2019 Cardiogenic Shock Plaque 
Dr. Smith's ECG Blog
OCTOBER 24, 2019
Here’s the angiogram of the RCA : No thrombus or plaque rupture in the RCA (or any coronary artery) was found. This MI wasn’t caused by a ruptured plaque of CAD - it was a coronary artery dissection of the RCA. were pretty sick, with mostly LM/pLAD lesions and high rates of cardiogenic shock. Lobo et al.
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.
Dr. Smith's ECG Blog
OCTOBER 20, 2024
There are multiple possible clinical situations that could account for diffuse subendocardial ischemia that is not due to ACS and plaque rupture. On arrival in the emergency department, invasive blood pressure was 35/15mmHg and the patient was in profound cardiogenic shock with severe confusion secondary to brain hypoperfusion.
Dr. Smith's ECG Blog
OCTOBER 7, 2019
Why is the patient in shock? He was in profound cardiogenic shock. He was taken to the cath lab and underwent emergent intervention: Thrombotic stenosis of the proximal RCA (95% with evidence of plaque rupture) is the culprit for the patient's inferoposterior STEMI. There is an obvious inferior STEMI, but what else?
Dr. Smith's ECG Blog
JANUARY 15, 2024
Tachycardia is unusual for OMI, unless the patient is in cardiogenic shock (or getting close). As an aside, the LCx OMI is a type 2 event, since it is due to supply-demand mismatch from thrombus, and not due to atherosclerotic plaque rupture or erosion). The September 22, 2019 post — intermittent ST-T wave artifact.
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