Dr. Smith's ECG Blog
MAY 26, 2023
A 20-something presented after a huge verapamil overdose in cardiogenic shock. Today's patient is a young male who presented in cardiogenic shock following a massive verapamil overdose. He had been seen at an outside institution and been given 6 g calcium gluconate, KCl, and a norepinephrine drip. The initial K was 3.0
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. And then, 15 minutes later in today's case — this patient was in cardiogenic shock. As per Dr.
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
The patient in today’s case presented in cardiogenic shock from proximal LAD occlusion, in conjunction with a subtotally stenosed LMCA. There was no evidence bradycardia leading up to the runs of PMVT ( as tends to occur with Torsades ). LAD — 100% proximal occlusion; with 70-89% mid-vessel narrowing.
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.
Dr. Smith's ECG Blog
MAY 30, 2023
Here is his ED ECG: There is bradycardia with a junctional escape. Case continued A bedside ultrasound showed diminished LV EF and of course bradycardia. RVMI explains part of the shock. BP was 108 systolic (if a cuff pressure can be trusted) but appeared to be maintaining BP only by very high systemic vascular resistance.
Dr. Smith's ECG Blog
JUNE 19, 2023
Soon afterward, the patient’s symptoms return along with lightheadedness, bradycardia, and hypotension. The patient has also developed sinus bradycardia, which may result from right coronary artery ischemia to the SA node. The Queen of Hearts agrees: Around this time his initial high sensitivity troponin I resulted at 231 ng/L.
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