Table of Contents

ABSTRACT

Sudden cardiac death, defined as death within 24 hours of last being seen well or within one hour of symptom onset, accounts for a significant proportion of deaths. A 57-year-old man was admitted to the emergency room after complaining of weariness for three days. His ECG revealed AV dissociation with ventricular escape rhythm and a heart rate of barely 30 beats per minute. The patient suffered a tonic clonic seizure with progressing bradycardia a few minutes after being admitted. A subsequent assessment revealed that the patient was unconscious and had a faint pulse. The patient was then given immediate cardio-pulmonary resuscitation (CPR). Rhythm analysis revealed alternating true asystole and ventricular fibrillation. We resuscitated the patient in accordance with ACLS standards. When the patient’s pulse returned, the ECG returned to sinus rhythm. To our surprise, the patient was able to speak directly after regaining spontaneous circulation. Early CPR, which acted as mechanical inotropes in our situation, resulted in a very positive outcome, with the patient alert and able to speak immediately after ACLS treatment.

Keywords: bradycardia, early CPR, hypoxic seizure, pre-arrest sign