94 M with CAD s/p 4V-CABG [**3420**] and CRI had been doing well until this
   AM when he was out walking with his wife.  [**Name (NI) **] abruptly syncopized and a bystander started CPR quickly.  The local fire department delivered two shocks without success.  Then EMS came and gave two more shocks and he went back into sinus.  It is unclear whether he regained
   consciousness.  He was intubated then brought to [**Hospital1 5**] ED.
   .
    In the ED, his intial SBP was reported to be 110.  Labs show K 2.7 and
   Hct 25.  He was given 40mEq of KCL.  On repeat labs, his K normalized
   and his Hct was 33 without any blood.  It is unclear whether one of the
   labs was erroneous. 
   the vitals were recorded as: T=34.8, HR 62, 132/74, 18, 100% on AC 18x500, FiO2 100%.   
 
   EKG: Sinus at 80 BPM with LAD, prolonged PR, TD 0.5 to 1mm in V4-V6
    .
   ECHO:
   The left atrium and right atrium are normal in cavity size. There is
   mild symmetric left ventricular hypertrophy with normal cavity size.
   There is mild global left ventricular hypokinesis (LVEF = 45-50 %). The
   right ventricular free wall is hypertrophied. Right ventricular chamber
   size is normal. with normal free wall contractility. The aortic root is
   mildly dilated at the sinus level. The ascending aorta is moderately
   dilated. The aortic valve leaflets (3) are mildly thickened but aortic
   stenosis is not present. Mild to moderate ([**1-13**]+) aortic regurgitation
   is seen. The mitral valve leaflets are mildly thickened. There is no
   mitral valve prolapse. Mild (1+) mitral regurgitation is seen. The
   tricuspid valve leaflets are mildly thickened. The estimated pulmonary
   artery systolic pressure is normal. There is a trivial/physiologic
   pericardial effusion.
   IMPRESSION: Mildly depressed global left ventricular function. Mild to
   moderate aortic regurgitation. Mild mitral regurgitation.