Cardiac Arrest. What does the ECG show? Also see the bizarre Bigeminy.

A 60-something woman presented after a witnessed cardiac arrest. CPR was started immediately.  EMS arrived and found her in a wide complex PEA rhythm. She was given 3 mg IV epinephrine and multiple rounds of ACLS over approximately 20 minutes.Her husband stated that she had not been feeling well in the past 2 weeks and c/o dizziness as well as diarrhea.She was never defibrillated.I was texted this ECG in real time, but it turns out to actually be the 2nd one recorded in the ED.What do you think?This is what I wrote:This looks like pseudoSTEMI to me.  What appears to be ST elevation seems to be a wide QRS.  I am only looking on my phone though.Indeed, if you find the end of the QRS, which is easy to see in V1, then draw a line down to lead II across the bottom, then you can find the end of the QRS in lead II.  The go to the left and find that same point under aVR/aVL/aVF and under I, II, III, and you can draw this line back up to find the end of the QRS in these leads.Sure enough, all of what you might think is ST Elevation is really QRS:The K returned at 2.7 mEq/L.  This is commonly found after epinephrine for cardiac arrest, but could have been pre-existing and a possible contributing factor to cardiac arrest.A recent similar case:A 40-something with chest pain. Is this inferior MI?Just as interesting is EKG 1, 24 minutes before the first:What do you think here?There is a bigeminy with very Bizarre looking PVCs.  These are frequently found in ca...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs