Post-cardiac arrest ECGs: evaluation of ischemia, dysrhythmias, and their mimics

ECG Weekly Workout with Dr. Amal Mattu


A 55-year-old man presents to the emergency department with nonspecific chest pain. 20 minutes into his evaluation he is found to be diaphoretic and unresponsive in cardiac arrest with ventricular fibrillation. The following ECG is obtained immediately after ACLS results in ROSC:

Before watching the video, look closely at this ECG and ask yourself:

    1. How accurate is the immediate post-ROSC ECG?
    2. How would you manage post-arrest patients with STEMI?
    3. How would you manage post-arrest patients without STEMI?