Dr. Smith's ECG Blog

AUGUST 28, 2020

Bad chest pressure with severe left shoulder pain 3 nights ago. Now appears to be in cardiogenic shock." However, cardiogenic shock usually takes some time to develop, so it is probably subacute." Cardiogenic shock and ACS is an indication for the cath lab, even if you don't think there is OMI.

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Cardiogenic Shock Chest Pain Ischemia Stenosis 52

Dr. Smith's ECG Blog

NOVEMBER 23, 2022

Case submitted by Rachel Plate MD, written by Pendell Meyers A man in his 70s presented with chest pain which had started acutely at rest and has lasted for 2 hours. The pain was still ongoing at arrival. He was in cardiogenic shock requiring an impella for several days after cath.

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Chest Pain Cardiac Arrest Cardiogenic Shock Heart attacks 52

Dr. Smith's ECG Blog

JUNE 19, 2023

The patient’s chest pain spontaneously resolved before he was evaluated and has a repeat ECG obtained at 22:12 obtained shown below. In context, of course, it is clear that the patient is reperfusing, as pain has dissipated and the diagnostic findings of OMI have become more nonspecific. This ECG is more difficult.

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Chest Pain STEMI Cardiogenic Shock Ischemia 52

Ken Grauer, MD

OCTOBER 25, 2024

P.S.: Cardiac cath was performed — and showed a distal LA D "culprit" lesion that was successfully stented. The following are the KEY clinical and ECG features that establish the diagnosis of W ellens ' S yndrome : There should be a history of prior chest pain that has resolved at the time the defining ECG is obtained.

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Blog Chest Pain Cardiogenic Shock STEMI 95

Dr. Smith's ECG Blog

MAY 8, 2023

Edits by Meyers and Smith A man in his 70s with PMH of hypertension, hyperlipidemia, type 2 diabetes, CVA, dual-chamber Medtronic pacemaker, presented to the ED for evaluation of acute chest pain. So the patient was taken for emergent cath, showing: Culprit artery: LAD (100% stenosis, TIMI 0) requiring thrombectomy and stent.

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Chest Pain Myocardial Infarction STEMI Pacemaker 52

Dr. Smith's ECG Blog

MAY 30, 2023

A 50-something man presented in shock with severe chest pain. The patient was in clinical shock with a lactate of 8. Angiogram: Culprit Lesion (s): Thrombotic occlusion of the proximal RCA -- stented. His prehospital ECG was diagnostic of inferior posterior OMI. He appeared gray in color, with cool skin.

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Chest Pain Myocardial Infarction STEMI Cardiogenic Shock 85

Dr. Smith's ECG Blog

NOVEMBER 3, 2023

A man in his 70s with past medical history of hypertension, dyslipidemia, CAD s/p left circumflex stent 2 years prior presented to the ED with worsening intermittent exertional chest pain relieved by rest. This episode of chest pain began 3 hours ago and was persistent even at rest. Troponin was ordered.

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Chest Pain Cardiogenic Shock Ischemia Myocardial Infarction 83