Blood Pressure Bradycardia Cardiogenic Shock 
Dr. Smith's ECG Blog
MAY 30, 2023
BP was 108 systolic (if a cuff pressure can be trusted) but appeared to be maintaining BP only by very high systemic vascular resistance. Here is his ED ECG: There is bradycardia with a junctional escape. This confirms inferior, posterior, lateral, and RV MI RV MI often leads to shock and (systolic) hypotension.
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 arterial blood gas showed a lactic acidosis with a lactate level of 17mmol/L. This is an ominous sign.
Dr. Smith's ECG Blog
OCTOBER 7, 2019
Why is the patient in shock? He was in profound cardiogenic shock. Both of these features make inferior + RV MI by far the most likely ( Pseudoanteroseptal MI is another name for this ) There is also sinus bradycardia and t he patient is in shock with hypotension. There is an obvious inferior STEMI, but what else?
Dr. Smith's ECG Blog
JULY 21, 2024
Immediately after contrast injection into the LMCA, the patient had circulatory collapse, with a precipitous drop in blood pressure. An Impella device was placed to maintain cardiac output and perfusion pressures. There was no evidence bradycardia leading up to the runs of PMVT ( as tends to occur with Torsades ).
Dr. Smith's ECG Blog
APRIL 6, 2025
They were unable to obtain a blood pressure. His heart rate was in the low 20s and we were also unable to obtain a blood pressure. He was given 50 mcg epinephrine with good response in both heart rate and blood pressure. His rhythm on telemetry seemed to be sinus bradycardia vs junctional rhythm.
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