Remove Cardiogenic Shock Remove Coronary Angiogram Remove Echocardiogram
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Critical Left Main

EMS 12-Lead

It’s judicious, then, to arrange for coronary angiogram. Coronary occlusion, however, might be present concurrently with subendocardial ischemia on the time-zero ECG, or evolve into such. Proximal LAD disease with/without a) and b) It seemed quite apparent that this was an Acute Coronary Syndrome. Coronary Angiogram 1.

Angina 52
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A man with chest pain off and on for two days, and "No STEMI" at triage.

Dr. Smith's ECG Blog

The patient is started on epinephrine infusion for cardiogenic shock and cardiology took the patient to the cath lab. During angiogram in the cath lab, the patient suffered two episodes of ventricular fibrillation for which he was successfully defibrillated. Two stents were placed with resultant TIMI 3 flow. Just another NSTEMI.

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Diffuse Subendocardial Ischemia on the ECG. Left main? 3-vessel disease? No!

Dr. Smith's ECG Blog

The diagnostic coronary angiogram identified only minimal coronary artery disease, but there was a severely calcified, ‘immobile’ aortic valve. Aortic angiogram did not reveal aortic dissection. Authors' commentary: Cardiogenic shock in the setting of severe aortic stenosis.

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90 year old with acute chest and epigastric pain, and diffuse ST depression with reciprocal STE in aVR: activate the cath lab?

Dr. Smith's ECG Blog

See this case: what do you think the echocardiogram shows in this case? An elderly man with sudden cardiogenic shock, diffuse ST depressions, and STE in aVR Literature 1. We investigated the incidence of an acutely occluded coronary in patients presenting with STE-aVR with multi-lead ST depression. Left main?