Cardiogenic Shock Chest Pain Pulmonary 
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
JUNE 17, 2018
A middle-aged patient with lung cancer had presented to clinic complaining of generalized malaise, cough, and chest pain. Symptoms other than chest pain (malaise, cough in a cancer patient) 2. I have always said that tachycardia should argue against acute MI unless there is cardiogenic shock or 2 simultaneous pathologies.
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. In PE, there is almost always some hypoxia without any pulmonary edema.
Dr. Smith's ECG Blog
SEPTEMBER 17, 2023
large ASD, partial anomalous pulmonary venous return, significant tricuspid regurgitation, carcinoid valvular disease, etc,) 2) Conditions causing pressure overload of the RV. Any cause of pulmonary hypertension. There is normal axis, normal R-wave progression in the precordial leads and no intraventricular conduction abnormalities.
Ken Grauer, MD
AUGUST 16, 2024
PEARL # 2: In the absence of associated heart failure ( cardiogenic shock ) — sinus tachycardia is not a common finding in acute MI. Today’s patient presented to the ED not only with chest pain — but also with shortness of breath , therefore with a history potentially consistent with the diagnosis.
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. This includes, but is not limited to, PE, asthma/COPD exacerbation, hypoxic vasoconstriction from pneumonia, acute pulmonary hypertension exacerbation. Differences of Pulmonary Embolism T-waves from Wellens' T-waves: 1.
Dr. Smith's ECG Blog
NOVEMBER 19, 2016
It was edited by Smith CASE : A 52-year-old male with a past medical history of hypertension and COPD summoned EMS with complaints of chest pain, weakness and nausea. The patient was transported to the CCU for further medical optimization where a pulmonary artery catheter was placed.
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