2018 Cardiogenic Shock Tachycardia 
Dr. Smith's ECG Blog
FEBRUARY 16, 2020
A previously healthy 53 yo woman was transferred to a receiving hospital in cardiogenic shock. Here was the ECG: There is sinus tachycardia. Referring to Figure-1 — this 53-year old woman who presented in extremis with cardiogenic shock and an initial pH = 6.9, This was sent by a reader. and K was normal.
Ken Grauer, MD
AUGUST 16, 2024
I see the following: There is sinus tachycardia ( upright P wave with fixed PR interval in lead II ) — at the rapid rate of ~130/minute. Sinus Tachycardia and RAD — as already noted above. PEARL # 2: In the absence of associated heart failure ( cardiogenic shock ) — sinus tachycardia is not a common finding in acute MI.
Dr. Smith's ECG Blog
JUNE 17, 2018
There is sinus tachycardia. Sinus tachycardia, which exaggerates ST segments and implies that there is another pathology. I have always said that tachycardia should argue against acute MI unless there is cardiogenic shock or 2 simultaneous pathologies. Here is that ECG: What do you think?
Dr. Smith's ECG Blog
FEBRUARY 28, 2020
Tachycardia (or nearly) 2. Tachycardia, = 1.8. Finally , they found these independent predictors of PE: Note that tachycardia only has an Odds ratio of 1.8. Tachycardia is unusual in ACS unless there is cardiogenic shock or a second simultaneous pathology. Poor R-wave progression 4. Domed T-wave inversion 5.
Dr. Smith's ECG Blog
NOVEMBER 4, 2022
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! An elderly man with sudden cardiogenic shock, diffuse ST depressions, and STE in aVR Literature 1. A slightly prolonged QTc ( although this is difficult to assess given the tachycardia ).
Dr. Smith's ECG Blog
SEPTEMBER 19, 2023
A b rief chart review revealed his most recent echo in 2018, with LV EF 67%, “very small” inferior wall motion abnormality. I find AV dissociation in VT to be very difficult to differentiate from artifact, as there are always random blips on tachycardia tracings. Past medical history includes coronary stenting 17 years prior.
Dr. Smith's ECG Blog
OCTOBER 20, 2024
Figure B At this point, with the ECG changing from diffuse ST depression to widespread ST elevation and the patient presenting in cardiogenic shock, left main coronary artery (LMCA) occlusion is the likely diagnosis. And then, 15 minutes later in today's case — this patient was in cardiogenic shock.
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