A 53-year-old woman presents to the ED resuscitation suite following cardiac arrest. At a local shelter she was reported to have been experiencing “flu-like” symptoms and shortness of breath. On EMS arrival she was hyperventilating; subsequently, she collapsed and was pulseless and apneic. EMS performed ACLS, defibriillating twice. The patient arrived at the ED in cardiac arrest. PMH per EMS: HTN. Meds: nifedipine. Physical exam was consistent with the patient’s arrested state. Monitor rhythm: asytole. Treatment was initiated with ACLS measures resulting in restored circulation followed repeatedly by recurrent cardiac arrest. During one interval while circulation was restored, a 12-lead ECG was obtained (click on to enlarge). No old tracing was available for comparison.
1. What is your ECG interpretation?
2. What is your disease differential diagnosis?
3. What would you do?
Tracings is a learning module involving actual cases of patients and their ECGs that present to the Emergency Department. Topics are derived from the EM Model for Resident Education.
Filed under: Tracings |