Dr. Smith's ECG Blog

AUGUST 13, 2020

This was my response: If it is the right clinical situation, such as acute chest discomfort, it looks like proximal left anterior descending occlusion with right bundle branch block and left anterior fascicular block. Because of the tachcardia, I would expect her to be very poor left ventricular function and maybe Cardiogenic shock.

Tachycardia 52

Tachycardia AFIB Cardiogenic Shock Myocardial Infarction 52

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.

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Cardiogenic Shock Chest Pain Tachycardia Ischemia 52

Dr. Smith's ECG Blog

NOVEMBER 16, 2010

Here are more examples of wide complex tachycardia: these are all a mix of ventricular tachycardia and SVT with aberrancy. This 51 yo male complained of chest pain, then had a v fib arrest. He was in cardiogenic shock. There is tachycardia, and there is a wide complex.

Tachycardia 52

Tachycardia Cardiogenic Shock Chest Pain STEMI 52

Ken Grauer, MD

AUGUST 16, 2024

I see the following: There is sinus tachycardia ( upright P wave with fixed PR interval in lead II ) — at the rapid rate of ~130/minute. Sinus Tachycardia and RAD — as already noted above. PEARL # 2: In the absence of associated heart failure ( cardiogenic shock ) — sinus tachycardia is not a common finding in acute MI.

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Blog Tachycardia Cardiogenic Shock Pulmonary 157

Dr. Smith's ECG Blog

OCTOBER 26, 2010

This 54 year old patient with a history of kidney transplant with poor transplant function had been vomiting all day when at 10 PM he developed severe substernal crushing chest pain. ACS and STEMI generally do not cause tachycardia unless there is cardiogenic shock. He had this ECG recorded. Are the lungs clear?

STEMI 52

STEMI Cardiogenic Shock Tachycardia Aneurysm 52

Dr. Smith's ECG Blog

JULY 21, 2024

The patient in today’s case is a previously healthy 40-something male who contacted EMS due to acute onset crushing chest pain. The pain was 10/10 in intensity radiating bilaterally to the shoulders and also to the left arm and neck. Written By Magnus Nossen — with edits by Ken Grauer and Smith. The below ECG was recorded.

Arrhythmia 118

Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 118

Dr. Smith's ECG Blog

MARCH 12, 2018

The findings include sinus tachycardia, characteristic QRS morphology most diagnostic in V3 with a small R wave followed by a very large S wave with a convex upward ST segment morphology, ST segment strain morphology in the inferior and anterior leads leading to deep symmetric T-wave inversion. The T-waves simply look different in Wellens'.

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Chest Pain Pulmonary Embolism Tachycardia 52

Dr. Smith's ECG Blog

OCTOBER 8, 2023

All of the patients presented with chest pain , and they are all in triage. The patient died of cardiogenic shock within 24 hours despite mechanical circulatory support. Triage is backed up, and 10 minutes into your shift one of the ED nurses brings your several ECG s that has not been overread by a physician.

Ischemia 114

Ischemia Chest Pain Cardiogenic Shock Cardiac Arrest 114

EMS 12-Lead

JULY 24, 2023

But the symptoms returned with similar pattern – provoked by exertion, and alleviated with rest; except that on each occasion the chest pain was a little more intense, and the needed recovery period was longer in duration. Severe Tachycardia Acute Coronary Syndrome (obstructive coronary disease) a. This results in Type I MI.

Angina 52

Angina Ischemia Coronary Angiogram Stenosis 52

Dr. Smith's ECG Blog

FEBRUARY 28, 2020

Tachycardia (or nearly) 2. And some similar ECGs from Pulmonary Embolism: A young woman with altered mental status and hypotension An elderly woman transferred to you for chest pain, shortness of breath, and positive troponin - does she need the cath lab now? Tachycardia, = 1.8. Poor R-wave progression 4.

Chest Pain 52

Chest Pain Pulmonary Tachycardia Embolism 52

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. Authors' commentary: Cardiogenic shock in the setting of severe aortic stenosis. Fundamentally, cardiogenic shock is an issue of decreased cardiac output.

Ischemia 52

Ischemia Cardiogenic Shock Aortic Stenosis 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

The best course is to wait until the anatomy is defined by angio, then if proceeding to PCI, add Cangrelor (an IV P2Y12 inhibitor) I sent the ECG and clinical information of a 90-year old with chest pain to Dr. McLaren. An elderly man with sudden cardiogenic shock, diffuse ST depressions, and STE in aVR Literature 1.

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52

Dr. Smith's ECG Blog

AUGUST 9, 2019

His comments/questions are inserted below the ECG: A 50-something woman presented with 3 days of intermittent chest pain that became worse on the day of presentation, with diaphoresis and radiation to the left arm, as well as abdominal pain. This is her ECG: An obvious STEMI, but which artery?

Myocardial Infarction 52

Myocardial Infarction Ischemia STEMI Cardiogenic Shock 52

Wellnest

JULY 19, 2023

When a person experiences a heart attack or myocardial infarction, they may feel chest pain and other symptoms in different parts of their body. The abnormal heart rhythms can further lead to death because of ventricular tachycardia and ventricular fibrillation. So, how do you recognize a heart attack?

Heart Attack 52

Heart Attack Heart attacks Blood Pressure Myocardial Infarction 52