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Pulseless Electrical Activity (known commonly as PEA) is a condition where the electrical activity of the heart is not accompanied by a palpable pulse. Treatable causes include pulmonary thrombosis, coronary thrombosis, tension pneumothorax, cardiac tamponade, hypovolemia, hyperkalemia, hypoxia and acidosis. It’s important that we rule out the treatable H’s and T’s as underlying causes for PEA in order to correct the mechanical dissociation causing the cardiac arrest. The ECG interpretation can appear the same as a normal sinus rhythm. Therefore in PEA, it is important to treat the symptoms of the patient and not merely the rhythm displayed on the monitor.