test post
Case submitted by Magnus Nossen MD from Norway, written by Pendell Meyers A man in his 50s with no pertinent medical history suffered a witnessed cardiac arrest. EMS found the patient in VFib and performed ACLS for 26 minutes then obtained ROSC. 12 minutes later, the patient went back into VFib arrest and underwent another 15 minutes of resuscitation followed by successful defibrillation and sustained ROSC. In total, he received approximately 40 minutes of CPR and 7 defibrillation attempts. Here is his first ECG recorded after stable ROSC: Originally recorded in 50 mm/s (the standard in Norway), here converted to 25 mm/s. There is sinus rhythm with a relatively normal QRS complex followed by a hint of STD that is maximal in V4-V6, which appears to me to be an expected amount of supply-demand mismatch ischemia from his immediately post-ROSC state. I do not see clear evidence of OMI or reperfusion at this time. The patient was transferred immediately for angiogram which revealed no sig