2019 Cardiogenic Shock Ischemia 
Dr. Smith's ECG Blog
FEBRUARY 16, 2020
A previously healthy 53 yo woman was transferred to a receiving hospital in cardiogenic shock. Our chief of cardiology, Gautam Shroff, interprets it differently and thinks this is indeed ischemia. Referring to Figure-1 — this 53-year old woman who presented in extremis with cardiogenic shock and an initial pH = 6.9,
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. There is no definite evidence of acute ischemia. (ie, Simply stated — t he patient was having recurrent PMVT without Q Tc prolongation, and without evidence of ongoing transmural ischemia. (
Dr. S. Venkatesan MD
DECEMBER 29, 2023
Cardiogenic shock (CS)is the most feared event following STEMI. This can be simply a equivalent of HT, with no true supply side ischemia with LVF with global ST depression ) Management *More or less similar to STEMI with aggressive opening of culprit lesions with few differences. SCAI 2019 Catheter Cardiovasc Interv.2019;94:29–37
Dr. Smith's ECG Blog
NOVEMBER 4, 2022
His response: “subendocardial ischemia. Smith : It should be noted that, in subendocardial ischemia, in contrast to OMI, absence of wall motion abnormality is common. With the history of Afib, CTA abdomen was ordered to r/o mesenteric ischemia vs ischemic colitis vs small bowel obstruction. Am J Med 2019, 132(5):622-630.
Dr. Smith's ECG Blog
APRIL 24, 2020
Contrary to what Ken stated, the ST vector remains mostly posterior __ What about subendocardial ischemia? Subendocardial ischemia results in ST depression, but unfortunately, and rather mysteriously, it does not localize to the ischemic wall. Similarly, STD in aVL is usually reciprocal to inferior ST elevation, not "lateral ischemia."
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.
Dr. Smith's ECG Blog
MAY 3, 2024
When I was shown this ECG, I said it looks like such widespread ischemia that is might be a left main occlusion, or LM ischemia plus circumflex occlusion (high lateral and posterior OMI). Today's patient did make it to the hospital — but was in cardiogenic shock, and despite valiant attempt at treatment, succumbed soon after.
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