Dr. Smith's ECG Blog

MAY 26, 2023

A 20-something presented after a huge verapamil overdose in cardiogenic shock. Today's patient is a young male who presented in cardiogenic shock following a massive verapamil overdose. He had been seen at an outside institution and been given 6 g calcium gluconate, KCl, and a norepinephrine drip. The initial K was 3.0

Cardiogenic Shock 98

Cardiogenic Shock Arrhythmia Blog Education 98

American College of Cardiology

SEPTEMBER 11, 2024

In this week’s View, Dr. Eagle looks at temporary mechanical circulatory support in infarct-related cardiogenic shock.

Cardiogenic Shock 53

Cardiogenic Shock AFIB Article 53

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. Today's patient did make it to the hospital — but was in cardiogenic shock, and despite valiant attempt at treatment, succumbed soon after.

Cardiogenic Shock 127

Cardiogenic Shock Cardiac Arrest Hospital Ischemia 127

Dr. Smith's ECG Blog

AUGUST 13, 2020

Because of the tachcardia, I would expect her to be very poor left ventricular function and maybe Cardiogenic shock. As per Dr. Smith — this suggests that despite QRS widening, the rhythm in ECG #3 is AFib with a rapid ventricular response. Old MI with persistent ST Elevation (LV aneurysm morphology) can look like acute MI 2.

Tachycardia 52

Tachycardia AFIB Cardiogenic Shock Myocardial Infarction 52

Dr. Smith's ECG Blog

JANUARY 15, 2024

Tachycardia is unusual for OMI, unless the patient is in cardiogenic shock (or getting close). The April 6, 2023 post — excessive baseline artifact misdiagnosed as AFib ( instead of sinus rhythm with AV Wenckebach — as in Figure-4 in this post ). We can see enough to make out that the rhythm is sinus tachycardia.

Chest Pain 64

Chest Pain Blog Arrhythmia Critical Care 64

Dr. Smith's ECG Blog

NOVEMBER 26, 2018

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. However we also noticed that the rhythm is rapid, regular, and narrow, with no P-waves, at a rate of approximately 200 bpm, and therefore not sinus rhythm in this patient in his 60s.

Ischemia 52

Ischemia Atrial Flutter Arrhythmia Tachycardia 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

With the history of Afib, CTA abdomen was ordered to r/o mesenteric ischemia vs ischemic colitis vs small bowel obstruction. An elderly man with sudden cardiogenic shock, diffuse ST depressions, and STE in aVR Literature 1. See this case: what do you think the echocardiogram shows in this case? Left main? 3-vessel disease?

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52