Blood Pressure Cardiogenic Shock Tachycardia 
Dr. Smith's ECG Blog
OCTOBER 26, 2010
He presented to the Emergency Department with a blood pressure of 111/66 and a pulse of 117. He was rushed by residents into our critical care room with a diagnosis of STEMI, and they handed me this ECG: There is sinus tachycardia with ST elevation in II, III, and aVF, as well as V4-V6. He had this ECG recorded. The HCO3 was 8.
Ken Grauer, MD
AUGUST 16, 2024
MY Thoughts on this CASE: Not being there — I am unaware of physical exam parameters ( blood pressure, respiratory rate; oxygen saturation; heart and lung auscultation, etc. ). I see the following: There is sinus tachycardia ( upright P wave with fixed PR interval in lead II ) — at the rapid rate of ~130/minute.
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. Still Irregular Blood pressure during these rhythms was adequate; there was no shock. Still Irregular Blood pressure during these rhythms was adequate; there was no shock.
Dr. Smith's ECG Blog
NOVEMBER 19, 2016
The initial blood pressure was 80/palp with a heart rate of 104, respirations 20, oxygen saturations of 94% and a finger stick blood glucose of 268. In addition, the patient received 750 mL of fluid resuscitation with transient improvement of blood pressure. If you can use Doppler, then you can diagnose it.
Dr. Smith's ECG Blog
MARCH 12, 2018
The findings include sinus tachycardia, characteristic QRS morphology most diagnostic in V3 with a small R wave followed by a very large S wave with a convex upward ST segment morphology, ST segment strain morphology in the inferior and anterior leads leading to deep symmetric T-wave inversion. and tachycardia, 1.8. incomplete RBBB 1.7
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
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. You can see Left Main and Proximal LAD obstruction, but with some flow, which is saving this patient's life.
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