Frontiers in Cardiovascular Medicine

JANUARY 10, 2024

The primary reason for OHCA was an acute coronary event (72%) followed by primary arrhythmia (9%) and non-ischemic cardiogenic shock (6.7%). Results Of the 171 analyzed patients (84% male, mean age 56 years), 12% survived the initial hospitalization with favorable neurological outcome.

Cardiac Arrest 59

Cardiac Arrest Cardiogenic Shock Hospital Arrhythmia 59

Open Heart

JUNE 5, 2024

vs 50.8%, p<0.001) and were more likely to experience postprocedural cardiogenic shock (4.5% vs 3.6%, p=0.019) and arrhythmia (11.2% SMuRF-less patients were more likely to present with cardiac arrest (6.6% vs 3.9%, p<0.001) and ST-elevation myocardial infarction (59.1% vs 9.9%, p=0.029).

Cardiogenic Shock 52

Cardiogenic Shock Myocardial Infarction Outcomes Coronary Artery Disease 52

Circulation

NOVEMBER 11, 2024

Topics included management of arrhythmias, structural heart disease, ischemia, cardiogenic shock, and post-procedure complications. Topics with high traffic included chapters regarding arrhythmias and post-procedural complications.

Cardiogenic Shock 40

Cardiogenic Shock Arrhythmia Article Ischemia 40

Dr. Smith's ECG Blog

OCTOBER 8, 2024

Click here to sign up for Queen of Hearts Access Here is the cardiologist's formal interpretation : "sinus rhythm with marked sinus arrhythmia, left ventricular hypertrophy with repolarization abnormality, and anteroseptal infarct, age undetermined." A temporary pacemaker was implanted, and she was admitted to the ICU with cardiogenic shock.

Cardiac Arrest 122

Cardiac Arrest Myocardial Infarction STEMI Cardiogenic Shock 122

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

Authors' commentary: Cardiogenic shock in the setting of severe aortic stenosis. This patient’s severe aortic stenosis (AS) and associated severe cardiogenic shock likely created the ECG pattern, resulting in a very difficult challenge for our inpatient team. If you can use Doppler, then you can diagnose it.

Ischemia 40

Ischemia Cardiogenic Shock Aortic Stenosis 40

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. Given that the patient was asymptomatic from these arrhythmias — there was time to contemplate additional measures. 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

JUNE 17, 2018

I have always said that tachycardia should argue against acute MI unless there is cardiogenic shock or 2 simultaneous pathologies. Other nonspecific findings may include P wave abnormalities, PR segment deviations, and atrial arrhythmias — though none of these findings are seen in a majority of patients.

Chest Pain 52

Chest Pain Pericarditis Tachycardia Myocardial Infarction 52

Dr. Smith's ECG Blog

OCTOBER 28, 2022

He has a pacemaker for an unknown arrhythmia reason, and has a hx of a PE but is not anti-coagulated currently. He went into cardiogenic shock and is intubated in the cardiac ICU. It started while walking, and began to decrease at rest but never fully resolved. It was central and constant.

Chest Pain 52

Chest Pain Myocardial Infarction Pacemaker Cardiogenic Shock 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

An elderly man with sudden cardiogenic shock, diffuse ST depressions, and STE in aVR Literature 1. This finding does not alter the need to pursue emergent reperfusion, although it might suggest a poorer prognosis.”[3] 2 cases of Aortic Stenosis: Diffuse Subendocardial Ischemia on the ECG. Left main? 3-vessel disease? Knotts et al.

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52

Dr. Smith's ECG Blog

OCTOBER 20, 2024

Figure B At this point, with the ECG changing from diffuse ST depression to widespread ST elevation and the patient presenting in cardiogenic shock, left main coronary artery (LMCA) occlusion is the likely diagnosis. The arrhythmia spontaneously converted before defibrillation was achieved. This is an ominous sign. As per Dr.

Cardiogenic Shock 127

Cardiogenic Shock Ischemia Chest Pain Cardiac Arrest 127

Dr. Smith's ECG Blog

JULY 21, 2024

The patient in today’s case presented in cardiogenic shock from proximal LAD occlusion, in conjunction with a subtotally stenosed LMCA. However, he suddenly developed a series of malignant ventricular arrhythmias. Below are printouts of some of the arrhythmias recorded. RCA — 100% proximal occlussion. What do you think?

Arrhythmia 130

Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 130

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 126

Cardiogenic Shock Cardiac Arrest Hospital Ischemia 126

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. In some cases the ischemia can be seen "through" the flutter waves, whereas in other cases the arrhythmia must be terminated before the ischemia can be clearly distinguished.

Ischemia 52

Ischemia Atrial Flutter Arrhythmia Tachycardia 52

Open Heart

OCTOBER 7, 2024

A novel risk score was developed, including the following parameters: male sex, age >70 years, non-white race, hypertension, hyperlipidemia, history of coronary artery bypass grafting, history of percutaneous coronary intervention, cardiac arrhythmias, renal failure, cardiogenic shock and vasopressor use.

Inpatient 52

Inpatient Coronary Artery Bypass Graft Cardiomyopathy Cardiogenic Shock 52

Dr. Smith's ECG Blog

OCTOBER 1, 2024

MY Initial Thoughts: In my experience — all-too-many emergency providers fail to appreciate the potential contribution that a brief ( 1-to-2 line ) history may convey when interpreting arrhythmias. The patient died of cardiogenic shock: Go to the post to see the full explanation. So he would not cath the patient.

Tachycardia 112

Tachycardia Cardiogenic Shock Arrhythmia STEMI 112

Circulation: Cardiovascular Interventions

FEBRUARY 20, 2024

NH-IMRangiowas calculated based on standard coronary angiographic views with 3-dimensional-modeling and computational analysis of the coronary flow.RESULTS:Overall, ECC (a composite of cardiovascular death, cardiogenic shock, acute heart failure, life-threatening arrhythmias, resuscitated cardiac arrest, left ventricular thrombus, post-ST-segment–elevation (..)

Myocardial Infarction 40

Myocardial Infarction STEMI Cardiogenic Shock Cardiac Arrest 40

Dr. Smith's ECG Blog

OCTOBER 8, 2023

The patient died of cardiogenic shock within 24 hours despite mechanical circulatory support. The axis is to the right and QRS complexes in lead I and aVL are predominantly negative suggesting LPFB. This patient at cath had a large CX occlusion with a massive troponin release. Troponin T >42.000ng/L.

Ischemia 121

Ischemia Chest Pain Cardiogenic Shock Cardiac Arrest 121

Dr. Smith's ECG Blog

JANUARY 15, 2024

Tachycardia is unusual for OMI, unless the patient is in cardiogenic shock (or getting close). Jenkins and Frick — I offer 3 additional examples of artifactual distortion ( excerpted from my ECG Blog ) — that resulted in arrhythmia misdiagnosis. We can see enough to make out that the rhythm is sinus tachycardia.

Chest Pain 63

Chest Pain Blog Arrhythmia Critical Care 63

Dr. S. Venkatesan MD

JANUARY 1, 2025

24) Microaxial Flow Pump in Infarct-Related Cardiogenic Shock DanGer Shock (ACC.24) 24) Microaxial Flow Pump in Infarct-Related Cardiogenic Shock DanGer Shock (ACC.24) Top 10 Clinical Trials Preventive PCI on Stenosis With Functionally Insignificant Vulnerable Plaque PREVENT (ACC.24)

Cardiogenic Shock 59

Cardiogenic Shock Plaque Academic Bicuspid/Mitral 59

Dr. Smith's ECG Blog

APRIL 9, 2025

1) as far as I can tell, there is very little data on amiodarone for this indication 2) amiodarone has beta blockade effects which could be deleterious in a patient with large anterior MI with pulmonary edema and at risk for cardiogenic shock (and she did go into shock. A second bolus of 50 mg followed in 5 minutes.

Defibrillator 62

Defibrillator Cardiac Arrest Myocardial Infarction STEMI 62