医学
心脏病学
背景(考古学)
内科学
冠状动脉闭塞
ST高程
心肌梗塞
急性冠脉综合征
肌钙蛋白
自然循环恢复
心导管术
心肌梗死诊断
闭塞
心电图
QRS波群
节奏
心肺复苏术
麻醉
复苏
古生物学
生物
作者
Alexander Bracey,H. Pendell Meyers,Stephen W. Smith
标识
DOI:10.1016/j.ajem.2020.12.028
摘要
A 72-year-old man presented to the ED following witnessed cardiac arrest. After return of spontaneous circulation, an ECG was performed which demonstrated a wide complex rhythm with "shark fin" morphology. With careful examination it is possible to identify the J point and determine that the electrocardiogram (ECG) findings actually represent massive ST-elevation indicative of occlusion myocardial infarction (OMI). Initial troponin was undetectable. The patient underwent emergent cardiac catheterization and had a 100% proximal LAD occlusion that was successfully stented. The patient was discharged home neurologically intact several days later. This case highlights the importance of careful ECG interpretation and the limitations of troponin assays in the evaluation of acute coronary syndrome. Most importantly, we demonstrate how to evaluate for ST elevation in the context of a widened QRS complex.
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