Cardiogenic Shock Chest Pain Embolism 
Dr. Smith's ECG Blog
OCTOBER 17, 2024
Written by Jesse McLaren Two patients in their 70s presented to the ED with chest pain and RBBB. Patient 1 : a 75 year old called paramedics with one day of left shoulder pain which migrated to the central chest, which was worse with deep breaths. Ten days later the patient returned with worsening pleuritic chest.
Dr. Smith's ECG Blog
SEPTEMBER 23, 2024
Taking a step back , remember that sinus tachycardia is less commonly seen in OMI (except in cases of impending cardiogenic shock). In patients with narrow QRS ( not this patient), this pattern is highly suggestive of acute pulmonary embolism. Additionally, there is borderline right axis deviation. Both were wrong.
Dr. Smith's ECG Blog
MARCH 12, 2018
Notice I did not say "pulmonary embolism," because any form of severe acute right heart strain may produce this ECG. Differences of Pulmonary Embolism T-waves from Wellens' T-waves: 1. Wellens' is a syndrome of a painless period following an anginal (chest pain) event. What is the answer? Here is an example of Wellens'.
DAIC
FEBRUARY 29, 2024
ET Main Tent (Hall B1) Self-expanding Versus Balloon-expandable Transcatheter Aortic Valve Replacement in Patients with Small Aortic Annuli: Primary Outcomes from the Randomized Smart Trial Effect of Edetate Disodium Based Chelation Infusions on Cardiovascular Events in Post-MI Patients with Diabetes: The TACT2 Trial Long-term Beta-blocker Treatment (..)
Dr. Smith's ECG Blog
FEBRUARY 28, 2020
No definite evidence of RV hypertrophy (normal axis, no large R-wave in V1) Late transition typical of COPD (R/S = 1 in V5) No evidence of old MI (no QS-waves in V1-V3, as seen in the presenting ECG) Other similar cases of acute right heart strain See this case of asthma whose ECG mimics acute PE: Is it pulmonary embolism? Kosuge et al.
Dr. Smith's ECG Blog
JANUARY 15, 2024
They had difficulty describing their symptoms, but complained of severe weakness, nausea, vomiting, headache, and chest pain. They described the chest pain as severe, crushing, and non-radiating. Tachycardia is unusual for OMI, unless the patient is in cardiogenic shock (or getting close).
Dr. Smith's ECG Blog
MARCH 25, 2025
Written by Willy Frick A woman in her 60s with very severe hyperlipidemia (LDL >200 mg/dL) presented with acute onset chest pain. She described the pain as moderate in severity, and said it had come and gone several times over the next few hours before ultimately resolving. Her symptoms began while getting off the bus.
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