{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T19:28:07Z","timestamp":1762025287646,"version":"build-2065373602"},"reference-count":0,"publisher":"California Digital Library (CDL)","issue":"4","license":[{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Practice and Cases in Emergency Medicine"],"abstract":"<p>Introduction: Coronary artery disease is uncommon in adults under the age of 35, and studies show a lower incidence in women of this age group. Physicians should suspect myocardial infarction in all patients who present with cardiac arrest and a shockable rhythm. Case Report: We report a case of a 34-year-old female who presented after return of spontaneous circulation following both pulseless electrical activity and ventricular fibrillation. The initial emergency department 12-lead electrocardiogram (ECG) demonstrated ST-segment elevation in the anterior precordial leads. The second, more notable, ECG showed a unique ischemic pattern of ventricular bigeminy with each beat containing a different morphology of injury pattern. Emergent cardiac catheterization found a 100% occlusion of the proximal left anterior descending artery. Conclusion: Premature ventricular (or junctional) contractions can indicate ischemia when the morphology consists of excessive discordance between the QRS complex and the ST segment and T wave. This case illustrates the importance of scrutinizing each beat in every lead to increase sensitivity for ischemia.<\/p>","DOI":"10.5811\/cpcem.38069","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T20:19:45Z","timestamp":1755548385000},"source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Bigeminy with Alternating Injury Pattern Morphologies in a Young Woman After Cardiac Arrest"],"prefix":"10.5811","volume":"9","author":[{"given":"Madelyn","family":"Huttner","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitchell","family":"McMurray","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sohail","family":"Ikram","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Huecker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"29705","published-online":{"date-parts":[[2025,8,18]]},"container-title":["Clinical Practice and Cases in Emergency Medicine"],"original-title":[],"link":[{"URL":"https:\/\/escholarship.org\/content\/qt3cr6b7pf\/qt3cr6b7pf.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T19:25:22Z","timestamp":1762025122000},"score":1,"resource":{"primary":{"URL":"https:\/\/escholarship.org\/uc\/item\/3cr6b7pf"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,18]]},"references-count":0,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,10,24]]}},"URL":"https:\/\/doi.org\/10.5811\/cpcem.38069","relation":{},"ISSN":["2474-252X"],"issn-type":[{"type":"electronic","value":"2474-252X"}],"subject":[],"published":{"date-parts":[[2025,8,18]]}}}