Journal of the Louisiana State Medical Society ECG of the M onth
Out-of-Hospital Cardiac Arrest
Stephanie C. El Hajj, MD; Curley J. Bordelon, MD; D. Luke Glancy, MD
Amuscular-appearing 50-year-old man was found down in his home by family members. Paramedics docu- mented pulseless electrical activity and began cardiopulmonary resuscitation that included placement of an endotracheal tube. The resuscitation was continued in the hospital emergency department (ED), and after 20 minutes, an arterial pulse returned. An electrocardiogram (ECG) was obtained (Figure 1). Meanwhile, a past history established that the patient was a personal trainer who seemed fit and healthy until 10 days earlier, when he came to the ED because he had begun to lose his balance and fall frequently. Computed tomography (CT) at that time revealed lytic lesions in the fifth lumbar vertebra and extensive retroperitoneal lymphadenopathy involving the aortic, iliac, and obturator chains and the perirectal region. Arrangements had then been made for outpatient workup of a presumed malignancy.
Figure 1: Electrocardiogram recorded in the emergency department. See text for explication.
What is your diagnosis?
Explication is on p. 177
176 J La State Med Soc VOL 166 July/August 2014
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