Blog Cardiogenic Shock Ultrasound 
Dr. Smith's ECG Blog
SEPTEMBER 23, 2024
Taking a step back , remember that sinus tachycardia is less commonly seen in OMI (except in cases of impending cardiogenic shock). Answer : Bedside ultrasound! Smith : RV infarct may also have this appearance on ultrasound. So hypoxia without B lines on lung ultrasound strongly weights toward PE. Both were wrong.
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. Another approach is sympathetic chain (stellate ganglion) blockade if you have the skills to do it: it requires some expertise and ultrasound guidance. RCA — 100% proximal occlussion.
Dr. Smith's ECG Blog
SEPTEMBER 19, 2023
Shocked x 2 without effect. Pads were placed with ultrasound guidance, so they were in the correct position. As I discussed and documented in Lesson 1 of My Comment at the bottom of the page in the April 2, 2022 post of Dr. Smith's ECG Blog — certain patients may remain in sustained VT not only for hours — but even for days!
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?
Dr. Smith's ECG Blog
NOVEMBER 19, 2016
Smith comment: This patient did not have a bedside ultrasound. Had one been done, it would have shown a feature that is apparent on this ultrasound (however, this patient's LV function would not be as good as in this clip): This is recorded with the LV on the right. In fact, bedside ultrasound might even find severe aortic stenosis.
Dr. Smith's ECG Blog
JANUARY 15, 2024
Tachycardia is unusual for OMI, unless the patient is in cardiogenic shock (or getting close). ECG 2 Especially in the context of the first ECG, readers of this blog will readily appreciate the ST elevations and hyperacute T waves in II, III, aVF, V6, and to a lesser extent V5. link] I also texted the ECG to Dr. Smith.
Dr. Smith's ECG Blog
MAY 30, 2023
Case continued A bedside ultrasound showed diminished LV EF and of course bradycardia. RVMI explains part of the shock. OTHER Examples of Lead Reversal on Dr. Smith's Blog: Technical errors featuring a variety of lead reversal placements remain a surprisingly common “mishap” of everyday practice.
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