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National Cardiogenic Shock Initiative Study Results Show Significant Increase in Heart Attack Survival

DAIC

Henry Ford Health's National Cardiogenic Shock Initiative research team. Cardiogenic shock is a critical condition in which the heart is unable to pump enough blood to sustain the body’s needs, depriving vital organs of blood supply. This can cause those organs to eventually stop functioning.

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Interhospital Variation in Admissions Managed With Critical Care Therapies or Invasive Hemodynamic Monitoring in Tertiary Cardiac Intensive Care Units: An Analysis From the Critical Care Cardiology Trials Network Registry

Circulation: Cardiovascular Quality & Outcomes

Circulation: Cardiovascular Quality and Outcomes, Ahead of Print. Admissions to CICUs with the highest tertile of CCRx utilization had a greater burden of comorbidities, had more diagnoses of ST–elevation myocardial infarction, cardiac arrest, or cardiogenic shock, and had higher Sequential Organ Failure Assessment scores.

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See this "NSTEMI" go unrecognized for what it really is, how it progresses, and what happens

Dr. Smith's ECG Blog

The notes now refer to the patient being in cardiogenic shock, on pressors. hours from presentation, where he was found to have an acute thrombotic LAD occlusion which was stented with resulting TIMI 3 flow, but still the patient was in severe cardiogenic shock. Academic Emergency Medicine 27(S1): S220; May 2020.

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Chest pain and shock: Is there a right ventricular OMI on this ECG? And should he undergo trancutaneous pacing?

Dr. Smith's ECG Blog

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. I say academically because the STD in V2 is diagnostic -- posterior leads are NOT necessary. What to do? STE and STD were measured at the J-point, relative to the PQ junction.

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What is the infarct artery? What does the post PCI ECG show? What does the convalescent ECG show?

Dr. Smith's ECG Blog

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. Thus, this ECG predicts poor myocardial perfusion and poor outcome.

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Arrhythmia? Ischemia? Both? Electricity, drugs, lytics, cath lab? You decide.

Dr. Smith's ECG Blog

The axiom of "type 1 (ACS, plaque rupture) STEMIs are not tachycardic unless they are in cardiogenic shock" is not applicable outside of sinus rhythm. Again, not an expected outcome with diltiazem). I limit my comments to a number of academic and semantic concepts relating to the arrhythmia in this case: What is an “SVT”?