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Challenges in Clinical Electrocardiography
February 6, 2017

A Patient With Hypertrophic Cardiomyopathy Presenting in Cardiac Arrest

Author Affiliations
  • 1Department of Medicine, University of California-San Francisco, San Francisco
  • 2Division of Cardiology, Department of Medicine, University of California-San Francisco, San Francisco
  • 3Division of Cardiology, Department of Medicine, San Francisco General Hospital, San Francisco, California
JAMA Intern Med. Published online February 6, 2017. doi:10.1001/jamainternmed.2016.8756

A man in his 40s with self-reported hypertrophic cardiomyopathy, hypertension, and obstructive sleep apnea presented in cardiac arrest owing to ventricular tachycardia/fibrillation. He reported feeling unwell on the afternoon of presentation with dizziness and blurry vision, and then abruptly lost consciousness with seizure-like activity. On the arrival of emergency services, he was found to be pulseless with a rhythm of ventricular fibrillation; he was resuscitated with return of spontaneous circulation, intubated, and brought to the emergency department where cooling was initiated. His initial electrocardiogram (ECG) is shown in the Figure, A.

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