article thumbnail

Case 8-2024: A 55-Year-Old Man with Cardiac Arrest, Cardiogenic Shock, and Hypoxemia

The New England Journal of Medicine

A 55-year-old man had an out-of-hospital cardiac arrest. An evaluation showed 2-mm ST-segment elevations in the inferior leads on electrocardiography, cardiogenic shock, and a new systolic murmur. A diagnosis was made.

article thumbnail

20-something with huge verapamil overdose and cardiogenic shock

Dr. Smith's ECG Blog

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

article thumbnail

Prognostic influence of mechanical cardiopulmonary resuscitation on survival in patients with out-of-hospital cardiac arrest undergoing ECPR on VA-ECMO

Frontiers in Cardiovascular Medicine

Introduction The use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) in extracorporeal cardiopulmonary resuscitation (ECPR) in selected patients after out-of-hospital cardiac arrest (OHCA) is an established method if return of spontaneous circulation cannot be achieved.

article thumbnail

Early Utilization of Mechanical Circulatory Support in Acute Myocardial Infarction Complicated by Cardiogenic Shock: The National Cardiogenic Shock Initiative

Journal of the American Heart Association

BackgroundAcute myocardial infarction complicated by cardiogenic shock (AMI‐CS) is associated with significant morbidity and mortality. mmol/L and cardiac power output was 0.67±0.29 watts. A total of 406 patients were enrolled at 80 sites between 2016 and 2020. Patients presented with a mean systolic blood pressure of 77.2±19.2 mm Hg,

article thumbnail

Reperfusion in Patients With ST-Segment–Elevation Myocardial Infarction With Cardiogenic Shock and Prolonged Interhospital Transport Times

Circulation: Cardiovascular Interventions

BACKGROUND:In patients with ST-segment–elevation myocardial infarction complicated by cardiogenic shock, primary percutaneous coronary intervention (pPCI) is the preferred revascularization option. pharmacoinvasive and 46.2% pharmacoinvasive and 46.2% The incidence of the primary safety outcome was 10.1% 1.09];P=0.08).CONCLUSIONS:In

article thumbnail

See what happens when a left main thrombus evolves from subtotal occlusion to total occlusion.

Dr. Smith's ECG Blog

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. This patient is actively dying from a left main coronary artery OMI and cardiac arrest from VT/VF or PEA is imminent!

article thumbnail

Timing of Initiation of Extracorporeal Membrane Oxygenation Support and Outcomes Among Patients With Cardiogenic Shock

Journal of the American Heart Association

BackgroundVenoarterial extracorporeal membrane oxygenation (ECMO) provides full hemodynamic support for patients with cardiogenic shock, but optimal timing of ECMO initiation remains uncertain. Among 8619 patients (median, 56.7 women), the median duration from admission to ECMO initiation was 14 (5–32) hours. 1.36];P=0.004).