Cardiac Arrest Cardiogenic Shock STEMI 
Dr. Smith's ECG Blog
JULY 9, 2024
Written by Pendell Meyers A man in his 50s was found by his family in cardiac arrest of unknown duration. Despite anticipation by many that the initial post-resuscitation ECG will show an obvious acute infarction — this expected "STEMI picture" is often not seen.
Dr. Smith's ECG Blog
OCTOBER 8, 2024
Subtle as a STEMI." (i.e., About 45 minutes after the second EKG, the patient was found in cardiac arrest. A temporary pacemaker was implanted, and she was admitted to the ICU with cardiogenic shock. Later the next day, she went into cardiac arrest again. This one is easy for the Queen.
Dr. Smith's ECG Blog
OCTOBER 17, 2024
Past medical history included RBBB without other cardiac history, but old ECG was not available. The prehospital and ED computer interpretation was inferior STEMI: There’s normal sinus rhythm, first degree AV block and RBBB, normal axis and normal voltages. Vitals were normal except for oxygen saturation of 94%. Vitals were normal.
Dr. Smith's ECG Blog
NOVEMBER 23, 2022
About an hour later, he was then found on the floor in cardiac arrest in the ED. He underwent CPR and then was shocked out of VF. He was in cardiogenic shock requiring an impella for several days after cath. His initial troponin T was 15 ng/L (only two hours since pain onset). No further troponins were measured.
Dr. Smith's ECG Blog
JUNE 11, 2021
The patient was brought to the ED as a possible Code STEMI and was seen directly by cardiology. Similarly, STEMI guidelines call for urgent angiography for refractory ischemia or electrical/hemodynamic instability, regardless of ECG findings. But by this time the patient went into cardiogenic shock and passed away.
Dr. Smith's ECG Blog
NOVEMBER 4, 2022
This has been termed a “STEMI equivalent” and included in STEMI guidelines, suggesting this patient should receive dual anti-platelets, heparin and immediate cath lab activation–or thrombolysis in centres where cath lab is not available. aVR ST segment elevation: acute STEMI or not? aVR ST Segment Elevation: Acute STEMI or Not?
Dr. Smith's ECG Blog
NOVEMBER 12, 2020
Lactate was 20, POC Cardiac US showed EF estimated at 30%, and formal echo showed EF of only 15%, and a normal RV. Assessment was severe sudden cardiogenic shock. In a series of 18 patients with COVID and ST elevation, 8 were diagnosed with STEMI, 6 of whom had an angiogram and it showed obstructive coronary disease.
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