Remove 2019 Remove Cardiogenic Shock Remove STEMI
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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. We tend to perceive CS as an exclusive complication of STEMI. The incidence is half of that of STEMI, i.e., 2.5-5%. might show little elevation with considerable overlap of left main STEMI vs NSTEMI ) 2.Onset How is CS in NSTEMI different ?

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

Dr. Smith's ECG Blog

A previously healthy 53 yo woman was transferred to a receiving hospital in cardiogenic shock. So Shark Fin really is just a dramatic representation of STEMI, and can be in any coronary distribution. So this is STEMI, right? This was sent by a reader. and K was normal. Here was the ECG: There is sinus tachycardia.

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

Dr. Smith's ECG Blog

The prehospital and ED computer interpretation was inferior STEMI: There’s normal sinus rhythm, first degree AV block and RBBB, normal axis and normal voltages. The paramedic notes called STEMI into question: “EMS disagree with monitor for STEMI callout. Vitals were normal except for oxygen saturation of 94%. Vitals were normal.

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

Dr. Smith's ECG Blog

The ECG shows obvious STEMI(+) OMI due to probable proximal LAD occlusion. The patient in today’s case presented in cardiogenic shock from proximal LAD occlusion, in conjunction with a subtotally stenosed LMCA. The pain was 10/10 in intensity radiating bilaterally to the shoulders and also to the left arm and neck.

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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

This has been termed a “STEMI equivalent” and included in STEMI guidelines, suggesting this patient should receive dual anti-platelets, heparin and immediate cath lab activation–or thrombolysis in centres where cath lab is not available. aVR ST segment elevation: acute STEMI or not? Am J Med 2019, 132(5):622-630.

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

Dr. Smith's ECG Blog

There is an obvious inferior STEMI, but what else? Why is the patient in shock? Besides the obvious inferior STEMI, there is across the precordial leads also, especially in V1. He was in profound cardiogenic shock. This STE is diagnostic of Right Ventricular STEMI (RV MI). A right sided ECG was not recorded.

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Extreme shock and cardiac arrest in COVID patient

Dr. Smith's ECG Blog

Assessment was severe sudden cardiogenic shock. In a series of 18 patients with COVID and ST elevation, 8 were diagnosed with STEMI, 6 of whom had an angiogram and it showed obstructive coronary disease. 12 All STEMI patients had very high cTn typical of STEMI (cTnT > 1.0 They recorded an EC G: New ST Elevation.