Dr. Smith's ECG Blog

SEPTEMBER 19, 2023

Past medical history includes coronary stenting 17 years prior. If you take old people with a history of MI (he had a stent), that percentage goes far higher since there is scar tissue that acts as a nidus for the PVCs that initiate VT. He had concurrent sharp substernal chest pain that resolved, but palpitations continued.

Tachycardia 139

Tachycardia Cardiogenic Shock Angina Coronary Angiogram 139

Dr. Smith's ECG Blog

NOVEMBER 3, 2023

A man in his 70s with past medical history of hypertension, dyslipidemia, CAD s/p left circumflex stent 2 years prior presented to the ED with worsening intermittent exertional chest pain relieved by rest. The notes now refer to the patient being in cardiogenic shock, on pressors. Published 2022 Feb 20. Am J Emerg Med.

Chest Pain 83

Chest Pain Cardiogenic Shock Ischemia Myocardial Infarction 83

Dr. Smith's ECG Blog

OCTOBER 8, 2024

She was taken to the cath lab, where she was found to have 100% in-stent restenosis of the proximal LAD. A temporary pacemaker was implanted, and she was admitted to the ICU with cardiogenic shock. For more on Precordial Swirl — See the October 15, 2022 post in Dr. Smith's ECG Blog ). She could not be resuscitated.

Cardiac Arrest 123

Cardiac Arrest Myocardial Infarction STEMI Cardiogenic Shock 123

Ken Grauer, MD

OCTOBER 25, 2024

P.S.: Cardiac cath was performed — and showed a distal LA D "culprit" lesion that was successfully stented. See the October 15, 2022 post ( including My Comment at the bottom of the page ) — for review and illustration of the concept of " Precordial Swirl " ( due to proximal LAD OMI ). = See below for full explanation ).

Blog 95

Blog Chest Pain STEMI Cardiogenic Shock 95

Dr. Smith's ECG Blog

MAY 30, 2023

Angiogram: Culprit Lesion (s): Thrombotic occlusion of the proximal RCA -- stented. The April 17, 2022 post ( Leads V1,V2 misplacement ). The May 24, 2022 post ( LA-LL reversal ). The May 26, 2022 post ( LA-LL reversal ). The August 17, 2022 post ( LA-RA reversal ). The November 19, 2020 post ( LA-LL reversal ).

Chest Pain 97

Chest Pain Myocardial Infarction STEMI Cardiogenic Shock 97

Dr. Smith's ECG Blog

NOVEMBER 23, 2022

He was taken to the cath lab where he was found to have acute total occlusion of his saphenous vein graft to his RCA, which was stented. He was in cardiogenic shock requiring an impella for several days after cath. No further troponins were measured. Such is the situation in today's post by Drs. Plate and Meyers.

Chest Pain 52

Chest Pain Cardiac Arrest Cardiogenic Shock Heart Attack 52

Dr. Smith's ECG Blog

MAY 8, 2023

This was several months after the 2022 ACC Guidelines adding modified Sgarbossa criteria as a STEMI equivalent in ventricular paced rhythm). So the patient was taken for emergent cath, showing: Culprit artery: LAD (100% stenosis, TIMI 0) requiring thrombectomy and stent. Modified Sgarbossa Criteria Refresher!

Chest Pain 52

Chest Pain Myocardial Infarction STEMI Pacemaker 52