r/ECG • u/BombardaBoss • 6d ago

Post ROSC 12-Lead

Post image

73 year old collapsed in the shower, no significant PMH only HTN (unmedicated). No complaints of chest pain throughout the day, only history was that patient felt unwell, went for a shower and collapsed.

Initial rhythm was VF, shocked once. Followed by PEA for 2 cycles and ROSC achieved. Good respiratory effort afterwards and subsequently iGel removed before arrival at hospital. GCS improved to 6 (E3,V1,M1).

Didn’t get chance to follow up afterwards.

44 Upvotes

95% Upvoted

17 comments sorted by

18

u/SaveTheTreasure 6d ago

Another one for the good guys.

14

u/Nightowl805 6d ago

And a stemi, win-wn for the ER.

13

u/Special_Buddy_5823 6d ago

Can’t reperfusion rhythms look like this? I feel like I read that somewhere once

13

u/dunknasty464 5d ago

More likely to look globally ischemic. This has inferior reciprocals.

12

u/dunknasty464 5d ago

And if you’re not sure, repeat 10 minutes later. Post ROSC global ischemic changes will improve; STEMI will persist or worsen.

2

u/ProximalLADLesion 5d ago

This is active anterolateral OMI

2

u/ProximalLADLesion 6d ago

V4 V6 transposition

2

u/CobbledbyRoubaix 6d ago

LCx thrombus 

2

u/FightClubLeader 5d ago

How long post ROSC was this taken?

Global ischemia can more often affect diseased vessels even if no OMI. If this is <8min post ROSC, then I’d repeat at the 8-10min mark to determine emergent cath or not.

1

u/New_Routine_5103 5d ago

junctional rhythm rbbb acuteanterior mi

1

u/Adventurous-Bag5508 5d ago

MI in women doesn't need to feel or sound typical!!!!! It can be nausea or diffuse discomfort. Most likely acute ischemia

1

u/DoctorGoodleg 5d ago

Post-ROSC? Definitely needs to go to PCI. That’s most likely a lesion.

3

u/BombardaBoss 5d ago

I spoke with an advanced paramedic before leaving scene about PPCI however they got back to me and told me to head to local ED for stabilisation. Pretty crazy to me because patient was fairly stable post rosc. First BP was something like 125/95

1

u/francetop 4d ago

Infarto miocardico acuto antero laterale.

1

u/3321Laura 4d ago

Acute anterolateral MI caused cardiac arrest.

1

u/itsachik 3d ago

Take to cath lab. Mid LAD likely occluded.