Dr. Smith's ECG Blog
OCTOBER 26, 2010
ACS and STEMI generally do not cause tachycardia unless there is cardiogenic shock. Then ACS (STEMI) might be primary; this might be cardiogenic shock. Even if this ECG is the first thing one sees (as it was for me), one should stop and think: "This is an unusual STEMI." Are the lungs clear? Is the patient cool and pale?
Circulation
NOVEMBER 11, 2024
L/min/m2, suggestive of myopericarditis with cardiogenic shock. Cervical adenopathy and hepatitis are more common in adults while coronary artery aneurysms are rarer. Subsequently, he developed chest pain with hypotension, diffuse ST elevations on ECG, and hsTropI of 638 ng/L. IABP was inserted. gm/dL, hemoglobin 9.3
Dr. Smith's ECG Blog
OCTOBER 6, 2023
His included cardiogenic shock, V Tach, AV block. This ECG is diagnostic of anterior LV aneurysm in the presence of RBBB. See more such cases of RBBB with LV aneurysm here. Smith: this is the definition of LV aneurysm) --Regional wall motion abnormality- apical anterolateral and apical inferior, akinetic.
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. Old MI with persistent ST Elevation (LV aneurysm morphology) can look like acute MI 2. Not all anterior LV aneurysm has a QS-wave. LV Aneurysm? Learning Points: 1. Would you give Thrombolytics?
Dr. Smith's ECG Blog
JULY 18, 2014
Case Continued 2 days later the patient became increasingly tachycardic, hypotensive, ashen, clammy (in cardiogenic shock) and had a new murmur. Additionally , these patients have a high incidence of LV aneurysm with mural thrombus. The initial troponin I was 23.7 ng/ml and was falling, confirming infarction days ago.
Dr. Smith's ECG Blog
OCTOBER 17, 2024
Peak troponin was a massive 500,000 ng/L, echo showed EF reduced to 20%, and follow up ECG showed LV aneurysm morphology with anterior Q wave and persisting ST elevation. As often emphasized by Dr. Smith — sinus tachycardia is not a common finding with acute OMI unless something else is going on (ie, cardiogenic shock ).
Dr. Smith's ECG Blog
MARCH 3, 2025
There are no Q-waves to suggest old inferior MI, or inferior aneurysm as the etiology of the ST Elevation. Whenever there is tachycardia, I am skeptical of OMI unless it has led to severely compromised ejection fracction with cardiogenic shock. Or I suspect that there is OMI simultaneous with another pathology.
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