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. He was successfully stented.

Bradycardia 52

Bradycardia Cardiogenic Shock STEMI Ischemia 52

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. Two stents were placed with resultant TIMI 3 flow.

Chest Pain 52

Chest Pain STEMI Cardiogenic Shock Ischemia 52

Dr. Smith's ECG Blog

OCTOBER 8, 2023

The patient was referred immediately for cath which revealed RCA occlusion that was stented. The patient died of cardiogenic shock within 24 hours despite mechanical circulatory support. There is some down sloping ST-segment and T wave inversion in lead aVL. The findings are diagnostic of inferior and posterior wall OMI.

Ischemia 112

Ischemia Chest Pain Cardiogenic Shock Cardiac Arrest 112

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. Angiogram: Culprit Lesion (s): Thrombotic occlusion of the proximal RCA -- stented. He appeared gray in color, with cool skin.

Chest Pain 85

Chest Pain Myocardial Infarction STEMI Cardiogenic Shock 85