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- W2323074920 abstract "HISTORY: 18 yo white male presents to the ER in cardiac arrest. He was eating when he collapsed. Heimlich maneuver was unsuccessful. EMS arrived in a few minutes and ACLS was started. Initial rythm was sinus tachycardia with change to ventricular fibrillation. He was defibrillated three times into sinus tachycardia. In the ER given amiodarone and hypothermia was induced. His girlfriend mentioned patient was complaining of palpitations and neck pain following intense physical activity during a four hour long Halloween haunted walk. Negative past medical history. Mother deceased secondary to cardiomyopathy. He is an avid snowboarder and works as snow board instructor. He denies illicit drug use. PHYSICAL EXAMINATION: Sedated on ventilation support. HR 55, BP 110/80. RRR,no murmur,S4 gallop. Lungs CTA B/L. Neuro:4mm fixed pupils, Neg Doll's eyes, neg blink reflex, no withdrawal to painfull stimuli. DIFFERENTIAL DIAGNOSIS: 1.STEMI 2.LQTS 3.Drug induced cardiac arrest 4.HCM 5.Brugada syndrome 6.CVA TEST AND RESULTS: EKG: Initial: right atrial enlargement, ST elevation and IVCD. Subsequent: sinus bradycardia, prolonged QT. Neg drug screen. NL blood glucose and LFT's. LDL 43,Cr 1.5, troponin 1.2, CK 7873,TG 252, CXR: Good ET tube placement, no pneumothorax, no fractures. Cardiac Cath: LV systolic dysfunction with normal coronary arteries. 2D ECHO: First day, EF 20 %, global hypokinesis, normal LV wall thickness. 5 days later: EF 40%, globalhypokinesis. 5 months later: EF 45% and questionable PFO. Neg CT head. Negative LQTS genetic testing FINAL WORKING DIAGNOSIS: Idiopathic sudden cardiac arrest TREATMENT AND OUTCOMES: After hypothermic protocol he was weaned off of the ventilator. Amiodarone was discontinued and an AICD was placed. Discharged on aspirine,lisinopril and carvedilol. On follow up visits, patient asking about return in physical activities, especially snowboarding. Only class 1a sports were recommended. He was last seen about one year following his cardiac arrest. He denied any new symptoms. His AICD was interrogated and found no ventricular fibrillation events. His AICD was adjusted to a higher VT zone. He was continued on beta-blocker medication to limit his heart rate. He is compliant with avoiding strenuous activities as recommended by 36th Bethesda Conference eligibility recommendations." @default.
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- W2323074920 date "2011-05-01" @default.
- W2323074920 modified "2023-09-25" @default.
- W2323074920 title "Sudden Cardiac Arrest in a Seasonal Holiday Performer" @default.
- W2323074920 doi "https://doi.org/10.1249/01.mss.0000400571.03535.ac" @default.
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