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The Weekend Effect Touches TAVR Too

CardiacWire

To uncover the weekend effects impact on TAVR , researchers analyzed over 82k TAVR hospitalizations between 2013 and 2021 and revealed that weekend patients faced a 45% higher risk of in-hospital mortality compared to weekday admissions.

TAVR 59
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How cardiogenic shock in NSTEMI is different from STEMI?

Dr. S. Venkatesan MD

Cardiogenic shock (CS)is the most feared event following STEMI. Non-STEMI vs. STEMI Cardiogenic Shock: Clinical Profile and Long-Term Outcomes. 2013 Nov;6(6):708-15. Epub 2013 Nov 12. The incidence is up to 5 to 10% with a mortality rate of around 50-60%. There is one less addressed issue in ACS literature.

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Abstract 4136694: Impact of left ventricular support devices on myocardial and pulmonary recovery in patients with cardiogenic shock treated with venoarterial extracorporeal membrane oxygenation

Circulation

Background:Venoarterial-extracorporeal membrane oxygenation (VA-ECMO) is used to treat cardiogenic shock. Conclusion:An LV support device may be associated with reduced mortality and increased success in weaning off VA-ECMO in patients with cardiogenic shock. to 1.36) but not in VA-ECMO with IABP (1.80

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Diffuse Subendocardial Ischemia on the ECG. Left main? 3-vessel disease? No!

Dr. Smith's ECG Blog

Authors' commentary: Cardiogenic shock in the setting of severe aortic stenosis. This patient’s severe aortic stenosis (AS) and associated severe cardiogenic shock likely created the ECG pattern, resulting in a very difficult challenge for our inpatient team. If you can use Doppler, then you can diagnose it. Circulation.

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How does Acute Total Left Main Coronary occlusion present on the ECG?

Dr. Smith's ECG Blog

7) The 2013 ACC/AHA STEMI guidelines consider this a “STEMI equivalent,” where thrombolytic therapy is not contraindicated (Evidence level B, no specific class of recommendation).(16) TIMI flow 0) is rare in the ED, as most either die before arrival or are recognized clinically due to cardiogenic shock.

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A man in his 70s with acute chest pain and paced rhythm.

Dr. Smith's ECG Blog

Impella (cardiac output augmentation device) placed for cardiogenic shock Unfortunately, the patient progressed to multiorgan failure with worsening cardiac output despite being maxed on pressors and a balloon pump. He expired 4 days later. Interestingly, this patient was seen in the ED for hypertension and headache 3 days earlier.

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90 year old with acute chest and epigastric pain, and diffuse ST depression with reciprocal STE in aVR: activate the cath lab?

Dr. Smith's ECG Blog

An elderly man with sudden cardiogenic shock, diffuse ST depressions, and STE in aVR Literature 1. Can J of Cardiol 2018, 34: 132-145 Here are some other cases: LVH, LBBB, RBBB, and RVH may manifest ST depression without any ischemia! 2 cases of Aortic Stenosis: Diffuse Subendocardial Ischemia on the ECG. Left main? 3-vessel disease?