Remove 2019 Remove Cardiogenic Shock Remove Myocardial Infarction
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How cardiogenic shock in NSTEMI is different from STEMI?

Dr. S. Venkatesan MD

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.

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

Dr. Smith's ECG Blog

The patient in today’s case presented in cardiogenic shock from proximal LAD occlusion, in conjunction with a subtotally stenosed LMCA. Troponin T peaked at 38,398 ng/L ( = a very large myocardial infarction, but not massive-- thanks to the pre-PCI spontaneous reperfusion, and rapid internvention!! ).

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Extreme shock and cardiac arrest in COVID patient

Dr. Smith's ECG Blog

Assessment was severe sudden cardiogenic shock. Clin Chem [Internet] 2020;Available from: [link] Smith mini-review: Troponin in Emergency Department COVID patients Cardiac Troponin (cTn) is a nonspecific marker of myocardial injury. Myocardial Infarction Type 2 and Myocardial Injury. What is it?

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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

Am J Med 2019, 132(5):622-630. New insights into the use of the 12-lead electrocardiogram for diagnosing acute myocardial infarction in the emergency department. An elderly man with sudden cardiogenic shock, diffuse ST depressions, and STE in aVR Literature 1. American Journal of Medicine 132(5):622-630; May 2019.

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

Dr. Smith's ECG Blog

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.

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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

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).

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

Dr. Smith's ECG Blog

LAD 80% mid LCx occluded mid (acute infarct lesion) RCA 80% mid. PCI mid LCx So this is an OMI (Occlusion Myocardial Infarction), but not a STEMI Echo: Decreased left ventricular systolic performance, mild/moderate. The patient went into cardiogenic shock and ultimately died of this MI. The cath lab was activated.