Remove 2018 Remove Cardiogenic Shock Remove Ultrasound
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A 50-something with Regular Wide Complex Tachycardia: What to do if electrical cardioversion does not work?

Dr. Smith's ECG Blog

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.

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Chest pain and shock: Is there a right ventricular OMI on this ECG? And should he undergo trancutaneous pacing?

Dr. Smith's ECG Blog

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 ).

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Noisy, low amplitude ECG in a patient with chest pain

Dr. Smith's ECG Blog

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.

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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

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?

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Chest Pain and Inferior ST Elevation.

Dr. Smith's ECG Blog

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.