Cardiac arrest presenting w/no pulse, but normal sinus rhythm

I really should know this as I've done Basic Life Support courses in which the examiner has gone into some depth about sinus rhythm, etc, but....is it possible for a cardiac arrest patient to have no pulse, but for the sinus rhythm to appear normal?

The situation I'm trying to set up is this: an A&E nurse receives what seems to be a normal cardiac arrest patient, but it turns out that there's a curse on the patient which causes his heart to literally disappear. What I need is some kind of glaring sign that this is not a typical cardiac arrest - something which would look almost like an 'X-File' of sorts.

Anyone know more about cardiology/emergency medicine than I do?

- Crunchy, more used to ENT than A&E

Hmmm. The EKG monitor, or telemetry monitor, picks up electrical signals from the heart, so if the heart "literally" disappeared, then I don't see how there could be a rhythm on the monitor. Or a pulse. Unless the heart is still there, but only invisible?

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The idea I had was that the heart has disappeared, but the curse 'fakes' the electrical activity. I wanted there to be something unusual about there being electrical activity to prompt them to look into the case in more detail.

Of course, since it is actually possible (duh, forgot about PEA) I might have to go with something else here...

Oh no, he's dead as a doornail They don't find out about the disappeared heart 'til the autopsy (theoretically, anyway)

asroc said:

If I remember my ER internships correctly a cardiac echo is a common (standard?) procedure in a case like this, to check if there is a reversible cause. That's a quick and noninvasive bedside test, so they ought to notice a missing heart long before any surgery.

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Aha, that would actually work really well. Is an echo commonly utilised in most cardiac arrest scenarios, or just unusual ones (such as this?)