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. Shocked x 2 without effect. Pads were placed with ultrasound guidance, so they were in the correct position. Past medical history includes coronary stenting 17 years prior. However, this is not SVT.

Tachycardia 141

Tachycardia Cardiogenic Shock Angina Coronary Angiogram 141

Dr. Smith's ECG Blog

MAY 30, 2023

Case continued A bedside ultrasound showed diminished LV EF and of course bradycardia. RVMI explains part of the shock. For review — GO TO: The June 4, 2018 post ( LA-LL reversal ). The July 29, 2018 post ( LA-RA reversal ). The November 4, 2018 post ( Leads V1,V2 misplacement ).

Chest Pain 86

Chest Pain Myocardial Infarction STEMI Cardiogenic Shock 86

Dr. Smith's ECG Blog

JUNE 17, 2018

I have always said that tachycardia should argue against acute MI unless there is cardiogenic shock or 2 simultaneous pathologies. My Comment, by KEN GRAUER, MD ( 6/17/2018 ): = Excellent case with insightful learning points explaining why these serial tracings are not indicative of acute inferior infarction.

Chest Pain 52

Chest Pain Pericarditis Tachycardia Myocardial Infarction 52

Dr. Smith's ECG Blog

JANUARY 15, 2024

Tachycardia is unusual for OMI, unless the patient is in cardiogenic shock (or getting close). A bedside ultrasound should be done to assess volume and other etiologies of tachycardia, but if no cause of type 2 MI is found, the cath lab should be activated NOW. The January 30, 2018 post — for PTA.

Chest Pain 67

Chest Pain Blog Critical Care Arrhythmia 67

Dr. Smith's ECG Blog

OCTOBER 24, 2019

Many of these issues were described in a prior post by Dr. Angie Lobo ( @aloboMD ) (For open-access reviews of this literature, see Saw 2016 , Saw 2017 , or Hayes 2018.) Often, intravascular ultrasound or intravascular optical coherence tomography is requeried to make the diagnosis. Lobo et al. The SCAD cases in Lobo et al.

Chest Pain 52

Chest Pain SCAD STEMI Cardiogenic Shock 52

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 emergent cardiology consult can be helpful for equivocal cases. Left main? 3-vessel disease?

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52