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 52

Cardiogenic Shock 52

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 126

Cardiogenic Shock Cardiac Arrest Hospital Ischemia 126

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 131

Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 131

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 40

Heart Failure Cardiogenic Shock Outcomes Cardiac Arrest 40

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 52

Cardiac Arrest COVID-19 Myocardial Infarction Cardiogenic Shock 52

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 73

Chest Pain STEMI Pulmonary Embolism 73

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 64

Chest Pain Blog Arrhythmia Critical Care 64

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 40

Bradycardia Cardiogenic Shock STEMI Ischemia 40

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 52

Chest Pain SCAD STEMI Cardiogenic Shock 52

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 52

Ischemia STEMI Stenosis Chest Pain 52

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 52

Ischemia Chest Pain Stenosis STEMI 52

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 52

Myocardial Infarction Chest Pain Cardiogenic Shock STEMI 52

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 52

Chest Pain Pulmonary Tachycardia Embolism 52

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 52

Research Coronary Artery Bypass Graft Aortic valve Congenital 52

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 52

Research Coronary Artery Bypass Graft Aortic valve Congenital 52

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 40

Cardiogenic Shock Myocardial Infarction Outcomes Angina 40

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 137

Cardiogenic Shock Chest Pain Tachycardia Cardiac Arrest 137

Dr. Smith's ECG Blog

APRIL 9, 2025

1) as far as I can tell, there is very little data on amiodarone for this indication 2) amiodarone has beta blockade effects which could be deleterious in a patient with large anterior MI with pulmonary edema and at risk for cardiogenic shock (and she did go into shock.

Defibrillator 60

Defibrillator Cardiac Arrest Myocardial Infarction STEMI 60