2019 and Cardiogenic Shock - Cardiovascular Update

Cardiovascular outcomes in long COVID-19: a systematic review and meta-analysis

Frontiers in Cardiovascular Medicine

JANUARY 28, 2025

Systematic search conducted without language restrictions from December 1, 2019 to June 31, 2022 on PubMed, EMBASE, Web of Science, Cochrane library, ProQuest Coronavirus Research Database, COVID-19 Living Overview of the Evidence (L-OVE) subset of Episteminokos and the World Health Organization (WHO) Covid-19 databases.

COVID-19

COVID-19 Cardiogenic Shock Cardiomyopathy Outcomes

How cardiogenic shock in NSTEMI is different from STEMI?

Dr. S. Venkatesan MD

DECEMBER 29, 2023

Cardiogenic shock (CS)is the most feared event following STEMI. Non-STEMI vs. STEMI Cardiogenic Shock: Clinical Profile and Long-Term Outcomes. SCAI 2019 Catheter Cardiovasc Interv.2019;94:29–37 The incidence is up to 5 to 10% with a mortality rate of around 50-60%. Reference 1.Martínez J Clin Med. 113.000262.

Cardiogenic Shock

Cardiogenic Shock STEMI Myocardial Infarction Document

A 53 yo woman with cardiogenic shock. Believe me, this is not what you think.

Dr. Smith's ECG Blog

FEBRUARY 16, 2020

A previously healthy 53 yo woman was transferred to a receiving hospital in cardiogenic shock. 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. Here was the ECG: There is sinus tachycardia.

Cardiogenic Shock

Cardiogenic Shock STEMI Pericarditis Blog

Webinars

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Abstract 4146823: Trends and Outcomes in Heart Failure Admissions and Cardiogenic Shock Among Patients with Congenital Heart Disease

Circulation

NOVEMBER 11, 2024

Cardiogenic shock rates were highest among SV-CHD patients, with significant fluctuations, followed by DV-CHD patients. Heart transplant rates were low but increased slightly in 2020 for patients without CHD, with DV and SV CHD patients showing fluctuating rates peaking in 2018 and 2019, then declining in 2020.

Cardiogenic Shock

Cardiogenic Shock Congenital Heart Disease Heart Failure Congenital

See what happens when a left main thrombus evolves from subtotal occlusion to total occlusion.

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.

Cardiogenic Shock

Cardiogenic Shock Ischemia Chest Pain Cardiac Arrest

Timing of Initiation of Extracorporeal Membrane Oxygenation Support and Outcomes Among Patients With Cardiogenic Shock

Journal of the American Heart Association

JANUARY 19, 2024

BackgroundVenoarterial extracorporeal membrane oxygenation (ECMO) provides full hemodynamic support for patients with cardiogenic shock, but optimal timing of ECMO initiation remains uncertain. Multivariable logistic regression evaluated the association between time from admission to ECMO initiation and in‐hospital death.

Cardiogenic Shock

Cardiogenic Shock Outcomes Cardiac Arrest Hospital

Changing Trends in Mechanical Circulatory Support Use and Outcomes in Patients Undergoing Percutaneous Coronary Interventions for Acute Coronary Syndrome Complicated With Cardiogenic Shock: Insights From a Nationwide Registry in Japan

Journal of the American Heart Association

DECEMBER 1, 2023

in the first quarter of 2019 to 58.3% After adjusting for the confounders, the risk difference in the fourth quarter of 2021 relative to the first quarter of 2019 for in‐hospital mortality was not significant (adjusted odds ratio, 0.84 [95% CI, 0.69–1.01]).ConclusionsOur The quarterly prevalence and outcomes were reported.

Cardiogenic Shock

Cardiogenic Shock Outcomes Aortic Hospital

Demographic and Regional Trends of Cardiogenic Shock–Related Mortality in Young Adults in the United States, 1999 to 2019

The American Journal of Cardiology

DECEMBER 13, 2023

Publication date: 15 January 2024 Source: The American Journal of Cardiology, Volume 211 Author(s): Marco Zuin, Claudio Bilato, Thach Nguyen, Ramesh Daggubati, Gianluca Rigatelli

Cardiogenic Shock

Sudden shock with a Nasty looking ECG. What is it?

Dr. Smith's ECG Blog

MAY 3, 2024

Some patients have baseline RBBB with LAFB, but in patients with likely ACS, these are associated with severe infarction with cardiac arrest, cardiogenic shock or impending shock. Today's patient did make it to the hospital — but was in cardiogenic shock, and despite valiant attempt at treatment, succumbed soon after.

Cardiogenic Shock

Cardiogenic Shock Cardiac Arrest Hospital Ischemia

What are treatment options for this rhythm, when all else fails?

Dr. Smith's ECG Blog

JULY 21, 2024

The patient in today’s case presented in cardiogenic shock from proximal LAD occlusion, in conjunction with a subtotally stenosed LMCA. LAD — 100% proximal occlusion; with 70-89% mid-vessel narrowing. LCx — 50-69% stenosis of the 1st marginal branch; with 100% distal LCx occlusion. RCA — 100% proximal occlussion.

Arrhythmia

Arrhythmia Cardiogenic Shock Bradycardia Defibrillator

Impact of Advanced Therapy Centers on Characteristics and Outcomes of Heart Failure Admissions

Circulation: Heart Failure

MARCH 8, 2024

A secondary analysis evaluated outcomes for severe HF hospitalizations (cardiogenic shock, cardiac arrest, and mechanical ventilation). Centers performing at least 1 heart transplant or left ventricular assist device were classified as ATCs. of centers), 525 037 (18.3%) were admissions to ATCs (5.5%

Heart Failure

Heart Failure Cardiogenic Shock Outcomes Cardiac Arrest

Extreme shock and cardiac arrest in COVID patient

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

Assessment was severe sudden cardiogenic shock. Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19). Association of Coronavirus Disease 2019 (COVID-19) With Myocardial Injury and Mortality. Clinically — the patient was felt to be in cardiogenic shock.

Cardiac Arrest

Cardiac Arrest COVID-19 Myocardial Infarction Cardiogenic Shock

Two patients with chest pain and RBBB: do either have occlusion MI?

Dr. Smith's ECG Blog

OCTOBER 17, 2024

As often emphasized by Dr. Smith — sinus tachycardia is not a common finding with acute OMI unless something else is going on (ie, cardiogenic shock ). Finally — Note that there is also T-QRS-D ( T erminal QRS D istortion ) in lead V3 ( See My Comment in the November 14, 2019 post for review and illustration of T-QRS-D criteria ).

Chest Pain

Chest Pain STEMI Pulmonary Embolism

Noisy, low amplitude ECG in a patient with chest pain

Dr. Smith's ECG Blog

JANUARY 15, 2024

Tachycardia is unusual for OMI, unless the patient is in cardiogenic shock (or getting close). The September 27, 2019 post — for the Rowlands & Moore article with the above-noted formulas for recognizing the “culprit” extremity. The September 22, 2019 post — intermittent ST-T wave artifact.

Chest Pain

Chest Pain Blog Arrhythmia Critical Care

A 40-Something male with a "Seizure," Hypotension, and Bradycardia

Dr. Smith's ECG Blog

OCTOBER 7, 2019

Why is the patient in shock? He was in profound cardiogenic shock. During transport, I had debated giving atropine for his bradycardia and cardiogenic shock, but was worried about making an already profoundly ischemic heart more ischemic, and chose instead to optimize preload with pressure bagging 1L NS.

Bradycardia

Bradycardia Cardiogenic Shock STEMI Ischemia

A young peripartum woman with Chest Pain

Dr. Smith's ECG Blog

OCTOBER 24, 2019

were pretty sick, with mostly LM/pLAD lesions and high rates of cardiogenic shock. JACC 2019 Sep 10;74(10):1290-1300. Lobo et al. examined SCAD presenting as STEMI (unlike Hassan et al. where more than 3/4 of cases were NSTEMI). The SCAD cases in Lobo et al. Despite this, there was a high rate of PCI success.

Chest Pain

Chest Pain SCAD STEMI Cardiogenic Shock

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

NOVEMBER 4, 2022

Am J Med 2019, 132(5):622-630. An elderly man with sudden cardiogenic shock, diffuse ST depressions, and STE in aVR Literature 1. Now there is a paper published in 2019 that proves the point beyond doubt, though makes it clear that this pattern is associated with very high mortality. J Electrocardiol 2013;46:240-8 2.

Ischemia

Ischemia STEMI Stenosis Chest Pain

Guess the culprit with ST Elevation in posterior leads

Dr. Smith's ECG Blog

APRIL 24, 2020

Just prior to transport, the patient became confused and agitated and, although blood pressure and pulse were OK, I was worried about cardiogenic shock. Diagnosis : Posterior MI, right? We intubated him. Cath lab The BP was 70/40 on arrival to the cath lab and received a balloon pump and norepinephrine.

Ischemia

Ischemia Chest Pain Stenosis STEMI

Should Troponin be a Vital Sign? Perhaps, but only if Interpreted Using Pre-test Probability.

Dr. Smith's ECG Blog

FEBRUARY 5, 2019

The patient went into cardiogenic shock and ultimately died of this MI. Regional wall motion abnormality (WMA): Regional WMA: Inferobasal (this is another name for posterior), akinetic, small. Regional WMA: Lateral , large, hypokinetic. Many come back "positive" and trigger many often unnecessary downstream tests.

Myocardial Infarction

Myocardial Infarction Chest Pain Cardiogenic Shock STEMI

Are these Wellens' waves?

Dr. Smith's ECG Blog

FEBRUARY 28, 2020

Tachycardia is unusual in ACS unless there is cardiogenic shock or a second simultaneous pathology. These points have been emphasized in many previous posts on Dr. Smith’s blog ( See the April 5, 2019 post , including My Comment at the bottom of that page ).

Chest Pain

Chest Pain Pulmonary Tachycardia Embolism

Published Research

Society of Thoracic Surgeons - Research

APRIL 20, 2023

Institutional Coronary Artery Bypass Case Volumes and Outcomes European Journal of Heart Failure October 2023 Makoto Mori Robotic Mitral Valve Repair for Degenerative Mitral Regurgitation The Annals of Thoracic Surgery August 2023 Carlos Diaz-Castrillion Volume-Failure to Rescue Relationship in Acute Type A Aortic Dissections: An Analysis of The Society (..)

Research

Research Coronary Artery Bypass Graft Aortic valve Congenital

Published Research

Society of Thoracic Surgeons - Research

APRIL 20, 2023

Institutional Coronary Artery Bypass Case Volumes and Outcomes European Journal of Heart Failure October 2023 Makoto Mori 1 Robotic Mitral Valve Repair for Degenerative Mitral Regurgitation The Annals of Thoracic Surgery August 2023 Carlos Diaz-Castrillion 2 Volume-Failure to Rescue Relationship in Acute Type A Aortic Dissections: An Analysis of The (..)

Research

Research Coronary Artery Bypass Graft Aortic valve Congenital

Differences in treatment and clinical outcomes in patients aged >=75 years compared with those aged <=74 years following acute coronary syndromes: a prospective multicentre study

Open Heart

DECEMBER 26, 2023

Methods A large-scale cohort study of patients with ST-elevation/non-ST-elevation myocardial infarction (MI)/unstable angina underwent coronary angiography (January 2015–December 2019). Patients were classified as older (≥75 years) and younger (≤74 years). vs 86.2%, p<0.001).

Cardiogenic Shock

Cardiogenic Shock Myocardial Infarction Outcomes Angina

One of those ECGs you need to instantly recognize, which learners may struggle with at first

Dr. Smith's ECG Blog

JANUARY 11, 2025

See our other cases with similar patters, to burn this deep into your brain files: Smith : In my experience, these cases of LAD OMI with RBBB and LAFB are either about to arrest, post-arrest, and/or in cardiogenic shock. The ST Elevation is NOT typical. It is ofen downsloping This one is also a wide complex tachycardia.

Cardiogenic Shock

Cardiogenic Shock Chest Pain Tachycardia Cardiac Arrest

Cardiovascular outcomes in long COVID-19: a systematic review and meta-analysis

How cardiogenic shock in NSTEMI is different from STEMI?

A 53 yo woman with cardiogenic shock. Believe me, this is not what you think.

Webinars

Abstract 4146823: Trends and Outcomes in Heart Failure Admissions and Cardiogenic Shock Among Patients with Congenital Heart Disease

See what happens when a left main thrombus evolves from subtotal occlusion to total occlusion.

Timing of Initiation of Extracorporeal Membrane Oxygenation Support and Outcomes Among Patients With Cardiogenic Shock

Changing Trends in Mechanical Circulatory Support Use and Outcomes in Patients Undergoing Percutaneous Coronary Interventions for Acute Coronary Syndrome Complicated With Cardiogenic Shock: Insights From a Nationwide Registry in Japan

Demographic and Regional Trends of Cardiogenic Shock–Related Mortality in Young Adults in the United States, 1999 to 2019

Sudden shock with a Nasty looking ECG. What is it?

What are treatment options for this rhythm, when all else fails?

Impact of Advanced Therapy Centers on Characteristics and Outcomes of Heart Failure Admissions

Extreme shock and cardiac arrest in COVID patient

Two patients with chest pain and RBBB: do either have occlusion MI?

Noisy, low amplitude ECG in a patient with chest pain

A 40-Something male with a "Seizure," Hypotension, and Bradycardia

A young peripartum woman with Chest Pain

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

Guess the culprit with ST Elevation in posterior leads

Should Troponin be a Vital Sign? Perhaps, but only if Interpreted Using Pre-test Probability.

Are these Wellens' waves?

Published Research

Published Research

Differences in treatment and clinical outcomes in patients aged >=75 years compared with those aged <=74 years following acute coronary syndromes: a prospective multicentre study

One of those ECGs you need to instantly recognize, which learners may struggle with at first

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