2018 Cardiogenic Shock Ultrasound 
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 ).
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.
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.
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?
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.
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.
Dr. Smith's ECG Blog
APRIL 9, 2025
On arrival in the ED, a bedside ultrasound showed poor LV function (as predicted by the Queen of Hearts) with diffuse B-lines. This is a helpful PEARL to be aware of since on occasion, acute ST-T wave changes of acute MI may only be seen in PVCs, and not in the rest of the tracing ( See My Comment in the October 8, 2018 post).
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