Conclusion: Stress Test To VF

EMS crew responded to a Heart Center for a 62 year old male Asian patient. Pt was found laying supine on floor beside a treadmill. He had a abrasion to upper lip. Staff at the heart center stated that this patient came in for his first visit to establish baseline stats. He was in the process of performing his stress test when he collapsed. Staff stated he went into VFib and was immediately defibrillated and had successful conversion with just one shock.

He is now fully alert and oriented and states he feels very well. He has no pain, no shortness of breath and no N/V.

He has been given no medication prior to EMS arrival.

PMH:
Bypass in 1996
CAD
Hyperlipidemia
Uncontrolled Hypertension

Medications:
Bupropion HCI
Lisinopril-Hydrochlorothiazide
Metoporlol succinate
Zyprexia

NKDA

I was able to obtain some of the EKG from the medical center that witnessed the arrest.
Going into VFib

Defibrillation

Post Defibrillation

EMS Crew 12 Lead

This patient was transported to a PCI center and went straight to Cath Lab.

What is your interpretation and treatment?

Up Date:
Patient went into V-fib arrest during nuclear stress test. Patient was immediately defibrillated to normal sinus rhythm. The patient’s cardiologist requested transport to Palmetto Health Cath Lab holding area for planned catheterization. EMS acquired 12-lead during transport and diverted the patient to the emergency department for STEMI activation. Catheterization documented widely patent left internal mammary to the left anterior descending artery. His native vessels were diffusely diseased with occlusion of all four vein grafts. Cardiac surgery was consulted and felt that revascularization would unlikely improve patient’s situation. Patient was referred to an electrophysiologist who implanted an intracardiac defibrillator (ICD). ICD was implanted and patient was discharged on 4/1/11.