Post-cardiac arrest ECGs: which arrest survivors should get emergent reperfusion therapy?

HPI

A 65-year-old man presents to the ED with substernal chest pain that radiated to the back and is associated with nausea. An ECG is obtained on arrival and is interpreted as normal. While obtaining a history, the patient becomes unresponsive and has a witnessed ventricular fibrillation arrest that responds to chest compressions. His post arrest ECG showed inferior STEMI.

Before watching this week's video, ask yourself these questions:

1. How frequently will patients with STEMI present with an initially normal ECG?
2. How accurate is the post-ROSC ECG in predicting STEMI?
3. In which post arrest patients is emergent cath lab activation indicated?

Presenting ECG — Post-cardiac arrest ECGs: which arrest survivors should get emergent reperfusion therapy?

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