Academic Cardiogenic Shock Chest Pain 
Dr. Smith's ECG Blog
MAY 30, 2023
A 50-something man presented in shock with severe chest pain. The patient was in clinical shock with a lactate of 8. We recorded an ECG in which V1-V3 were put in the position of V4R-V6R, and V4-6 were placed in V7-9 to (academically) confirm posterior OMI. He appeared gray in color, with cool skin. What to do?
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. This episode of chest pain began 3 hours ago and was persistent even at rest. Troponin was ordered.
Dr. Smith's ECG Blog
NOVEMBER 11, 2022
This pattern is essentially always accompanied by cardiogenic shock and high rates of VT/VF arrest, etc. The patient arrived to the ED in cardiogenic shock but awake. What is the Diagnosis in this 70-something with Chest Pain? 68 minutes with chest compressions, full recovery. Eur Heart J.
Dr. Smith's ECG Blog
JULY 21, 2024
The patient in today’s case is a previously healthy 40-something male who contacted EMS due to acute onset crushing chest pain. The pain was 10/10 in intensity radiating bilaterally to the shoulders and also to the left arm and neck. Distinction of PMVT vs VFib is an academic one in this case ).
Dr. Smith's ECG Blog
SEPTEMBER 19, 2023
He had concurrent sharp substernal chest pain that resolved, but palpitations continued. Over past 3 months, he has had similar intermittent episodes of sharp chest pain while running, but none at rest. Definitive diagnosis that ECG #1 is in fact VT is more than academic. Patient intubated.
Dr. Smith's ECG Blog
OCTOBER 6, 2023
This is one case where it made a difference: Right Ventricular MI seen on ECG helps Angiographer to find Culprit Lesion Nevertheless, it is sometimes a fun academic exercise to try to predict the infarct artery: An elderly patient had onset of chest pain one hour prior. His included cardiogenic shock, V Tach, AV block.
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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