Shock, bradycardia, ST Elevation in V1 and V2. Activate the Cath Lab?

A 60-something with h/o cirrhosis and diabetes called 911 because he felt sick and wasunable to move his lower extremities. On arrival he was bradycardic and hypotensive.He stated that starting approximately 7 hours prior the he felt that he was unable to feel his extremities. At some point after that he contacted his neighbor who came to check on him and called 911. On arrival to the stabilization room he says he can feel his extremities and and states that he justgenerally feels unwell. He denies any chest pain or shortness of breath.p.p1 {margin: 0.1px 0.0px 0.1px 0.2px; font: 11.0px Calibri}EMS reports that when they arrived to the scene he had a heart rate in the 40s withvery weak and thready peripheral pulses and altered mental status. He had a syncopal episode while getting into the EMS cart. He maintained pulses but wasashen and diaphoretic. He was largely unresponsive to voice during his transport to the hospital.BP systolic 60.p.p1 {margin: 0.1px 0.0px 0.1px 0.2px; font: 11.0px Calibri}Ultrasound revealed global dilation of all 4 chambers of the heart with poor contractility, a IVC that measured 2.4 cm, no significant B-lines in lung fields nor large pleural effusions.An ECG was recorded:No definite P-waves, Bradycardic, Regular, lots of artifact.There is ST Elevation in V1 and V2What do you think?p.p1 {margin: 0.1px 0.0px 0.1px 0.2px; font: 11.0px Calibri}Comment:  There is also a very wide QRS.  The regular rate suggest...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs