2024 Cardiogenic Shock Chest Pain 
Dr. Smith's ECG Blog
SEPTEMBER 12, 2024
Written by Pendell Meyers A man in his 40s called EMS for acute chest pain that awoke him from sleep, along with nausea and shortness of breath. Smith : LAD OMI with RBBB/LAFB is not only subtle on the ECG, but most of these patients are extremely ill: most I have seen are post-ROSC, in cardiogenic shock, or arrested shortly after.
Dr. Smith's ECG Blog
OCTOBER 17, 2024
Written by Jesse McLaren Two patients in their 70s presented to the ED with chest pain and RBBB. Patient 1 : a 75 year old called paramedics with one day of left shoulder pain which migrated to the central chest, which was worse with deep breaths. Do either, both, or neither have occlusion MI? Vitals were normal.
Dr. Smith's ECG Blog
OCTOBER 20, 2024
He woke up alert and with chest pain which he also had experienced intermittently over the previous few days. The history in today's case with sudden loss of consciousness followed by chest pain is very suggestive of ACS and type I ischemia as the cause of the ECG changes. What do you think? This is an ominous sign.
Dr. Smith's ECG Blog
SEPTEMBER 5, 2024
The VSR is what is causing the cardiogenic shock! Mechanical complications occur acutely and significantly alter hemodynamics leading to comp ensatory mechanism which usually involve vasoconstriction and tachycardia, both hallmarks of cardiogenic shock. PIRP is strongly associated with myocardial rupture.
Dr. Smith's ECG Blog
JANUARY 15, 2024
They had difficulty describing their symptoms, but complained of severe weakness, nausea, vomiting, headache, and chest pain. They described the chest pain as severe, crushing, and non-radiating. Tachycardia is unusual for OMI, unless the patient is in cardiogenic shock (or getting close).
Ken Grauer, MD
OCTOBER 25, 2024
The following are the KEY clinical and ECG features that establish the diagnosis of W ellens ' S yndrome : There should be a history of prior chest pain that has resolved at the time the defining ECG is obtained. The Chest Pain required for the definition of Wellens' Syndrome occurred at the time of coronary occlusion.
Dr. Smith's ECG Blog
MAY 3, 2024
Some patients have baseline RBBB with LAFB, but in patients with likely ACS, these are associated with severe infarction with cardiac arrest, cardiogenic shock or impending shock. Here are some cases of RBBB with LAFB: What is the Diagnosis in this 70-something with Chest Pain?
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