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?

STEMI 52

STEMI Cardiogenic Shock Tachycardia Aneurysm 52

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. An echocardiogram showed no hemopericardium, but D oppler showed a new small ventricular septal defect with left to right shunting. The initial troponin I was 23.7

STEMI 52

STEMI Pericarditis Myocardial Infarction Cardiogenic Shock 52

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.

Tachycardia 73

Tachycardia Pulmonary Chest Pain Stenosis 73