Cardiac Arrest During Summer Heatwave and an Unexpected ECG Pattern

ECG Weekly Workout with Dr. Amal Mattu

HPI

A 40-year-old man is found unconscious inside a car during a hot summer day. He is extricated by EMS and found to be in asystolic cardiac arrest. ROSC is achieved en route, and he is comatose and hyperthermic (39℃/102.2 ℉) on arrival to the ED. ECG 1 is obtained after intubation and initiation of a propofol infusion for sedation, ECG 2 is obtained after cooling and discontinuation of the propofol infusion:

Before watching the video, ask yourself:

    1. Which conditions are known to bring out the ST elevation pattern in ECG 1?
    2. What factors likely resulted in the resolution of this pattern in ECG 2?
    3. What scoring system can help make a diagnosis for this suspected condition?