Dr. Smith's ECG Blog

JULY 9, 2024

Written by Pendell Meyers A man in his 50s was found by his family in cardiac arrest of unknown duration. Meyers and Smith in the October 15, 2022 post of Dr. Smith's ECG Blog ). His family started CPR and called EMS, who arrived to find him in ventricular fibrillation. Restoration of sinus rhythm is evident in Figure-1.

Defibrillator 104

Defibrillator STEMI Cardiac Arrest Cardiogenic Shock 104

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

Lactate was 20, POC Cardiac US showed EF estimated at 30%, and formal echo showed EF of only 15%, and a normal RV. Assessment was severe sudden cardiogenic shock. NOTE: For those interested — I review in detail determination of the artifact “culprit extremity” in My Comment in the September 27, 2019 post of Dr. Smith’s ECG Blog.

Cardiac Arrest 52

Cardiac Arrest COVID-19 Myocardial Infarction Cardiogenic Shock 52

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. As we've often emphasized on Dr. Smith's ECG Blog — it is rare in practice to see LMCA occlusion, because most such patients die before reaching the hospital. RCA — 100% proximal occlussion.

Arrhythmia 116

Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 116

Dr. Smith's ECG Blog

MAY 26, 2023

A 20-something presented after a huge verapamil overdose in cardiogenic shock. This was a very complex case and the details are too much for an ECG Blog, but suffice it to say that, s hortly thereafter, the patient had an asystolic arrest and was resuscitated. The initial K was 3.0 mEq/L and ionized calcium was 5.5

Cardiogenic Shock 86

Cardiogenic Shock Arrhythmia Blog Education 86

Dr. Smith's ECG Blog

JULY 14, 2010

She arrived comatose and in cardiogenic shock and the following ECG was recorded. Before EMS arrived, she had "seizure activity" and became unresponsive. She was defibrillated successfully from ventricular fibrillation and developed a perfusing rhythm. She was intubated.

Cardiac Arrest 52

Cardiac Arrest Cardiogenic Shock Chest Pain Defibrillator 52

Dr. Smith's ECG Blog

NOVEMBER 11, 2022

This pattern is essentially always accompanied by cardiogenic shock and high rates of VT/VF arrest, etc. The patient arrived to the ED in cardiogenic shock but awake. Plus recommendations from a 5-member panel on cardiac arrest. This one of the highest risk OMI patterns possible to see on an ECG.

Cardiogenic Shock 52

Cardiogenic Shock Chest Pain Tachycardia Ischemia 52

Dr. Smith's ECG Blog

JUNE 11, 2021

But the lack of traditional Sgarbossa criteria is not reassuring enough for such high pretest probability (elderly patient with chest pain, out of hospital cardiac arrest and LBBB), and the Modified Sgarbossa Criteria confirms Occlusion MI in this case. But by this time the patient went into cardiogenic shock and passed away.

Chest Pain 52

Chest Pain Cardiac Arrest Ischemia Cardiogenic Shock 52