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. Clinically — the patient was felt to be in cardiogenic shock. They recorded an EC G: New ST Elevation. What is it? There is STE in V2-V6.

Cardiac Arrest 52

Cardiac Arrest COVID-19 Myocardial Infarction Cardiogenic Shock 52

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. This progressed to electrical storm , with incessant PolyMorphic Ventricular Tachycardia ( PMVT ) and recurrent episodes of Ventricular Fibrillation ( VFib ). RCA — 100% proximal occlussion.

Arrhythmia 116

Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 116

Dr. Smith's ECG Blog

NOVEMBER 11, 2022

There is sinus tachycardia (do not be fooled into thinking this is VT or another wide complex tachycardia!) This pattern is essentially always accompanied by cardiogenic shock and high rates of VT/VF arrest, etc. The patient arrived to the ED in cardiogenic shock but awake. Code STEMI was activated.

Cardiogenic Shock 52

Cardiogenic Shock Chest Pain Tachycardia Ischemia 52

EMS 12-Lead

JULY 24, 2023

Category 2 : An increase in myocardial oxygen demand due to tachycardia, elevated ventricular afterload (BP or aortic stenosis), or increased wall stretch (admittedly this latter is more complicated) or a decrease in oxygen supply due to hypotension, anemia, hypoxia, or a combination of all of the above. This results in Type I MI.

Angina 52

Angina Ischemia Coronary Angiogram Stenosis 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

An elderly man with sudden cardiogenic shock, diffuse ST depressions, and STE in aVR Literature 1. Thirty-six patients (36%) presented with cardiac arrest, and 78% (28/36) underwent emergent angiography. A slightly prolonged QTc ( although this is difficult to assess given the tachycardia ). Left main?

Ischemia 52

Ischemia STEMI Stenosis Coronary Artery Disease 52

Dr. Smith's ECG Blog

OCTOBER 8, 2023

The patient died of cardiogenic shock within 24 hours despite mechanical circulatory support. Smith: This bizarre ECG looks like a post cardiac arrest ECG with probable acidosis or hyperkalemia in addition to OMI. This patient at cath had a large CX occlusion with a massive troponin release. Troponin T >42.000ng/L.

Ischemia 112

Ischemia Chest Pain Cardiogenic Shock Cardiac Arrest 112