Dr. Smith's ECG Blog

JUNE 19, 2023

The patient’s chest pain spontaneously resolved before he was evaluated and has a repeat ECG obtained at 22:12 obtained shown below. Soon afterward, the patient’s symptoms return along with lightheadedness, bradycardia, and hypotension. It is unclear if he received aspirin at triage. This ECG is more difficult.

Chest Pain 52

Chest Pain STEMI Cardiogenic Shock Ischemia 52

Dr. Smith's ECG Blog

MAY 30, 2023

A 50-something man presented in shock with severe chest pain. The patient was in clinical shock with a lactate of 8. 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.

Chest Pain 81

Chest Pain Myocardial Infarction STEMI Cardiogenic Shock 81

Dr. Smith's ECG Blog

JULY 21, 2024

The patient in today’s case is a previously healthy 40-something male who contacted EMS due to acute onset crushing chest pain. The pain was 10/10 in intensity radiating bilaterally to the shoulders and also to the left arm and neck. Written By Magnus Nossen — with edits by Ken Grauer and Smith. The below ECG was recorded.

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. And she does not know that this is an overdose; she thinks it is a patient with chest pain!! Today's patient is a young male who presented in cardiogenic shock following a massive verapamil overdose. The initial K was 3.0

Cardiogenic Shock 86

Cardiogenic Shock Arrhythmia Blog Education 86

Dr. Smith's ECG Blog

OCTOBER 8, 2023

All of the patients presented with chest pain , and they are all in triage. The patient died of cardiogenic shock within 24 hours despite mechanical circulatory support. Triage is backed up, and 10 minutes into your shift one of the ED nurses brings your several ECG s that has not been overread by a physician.

Ischemia 112

Ischemia Chest Pain Cardiogenic Shock Cardiac Arrest 112

Dr. Smith's ECG Blog

MARCH 30, 2014

Then the notes mention "cardiogenic shock" but without any reference to a cardiac echo or to a chest x-ray. Now chest pain free. Cardiologist note says: "Elevated troponin explained by type II MI due to her shock." There is a junctional bradycardia. Was there pulmonary edema? What was the diagnosis?

Outcomes 52

Outcomes Cardiogenic Shock STEMI Chest Pain 52