Dr. Smith's ECG Blog

SEPTEMBER 19, 2023

Shocked x 2 without effect. Pads were placed with ultrasound guidance, so they were in the correct position. Cardiology was consulted and the patient underwent coronary angiogram which showed diffuse severe three-vessel disease. Coronary angiogram shows diffuse severe three-vessel disease. What to do now?

Tachycardia 139

Tachycardia Cardiogenic Shock Angina Coronary Angiogram 139

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

Smith comment: This patient did not have a bedside ultrasound. Had one been done, it would have shown a feature that is apparent on this ultrasound (however, this patient's LV function would not be as good as in this clip): This is recorded with the LV on the right. Aortic angiogram did not reveal aortic dissection.

Ischemia 40

Ischemia Cardiogenic Shock Aortic Stenosis 40

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

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. A emergent cardiology consult can be helpful for equivocal cases. Left main? 3-vessel disease?

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52

Dr. Smith's ECG Blog

MARCH 3, 2025

Whenever there is tachycardia, I am skeptical of OMI unless it has led to severely compromised ejection fracction with cardiogenic shock. I suspect pulmonary edema, but we are not given information on presence of B-lines on bedside ultrasound, or CXR findings. Or I suspect that there is OMI simultaneous with another pathology.

Tachycardia 74

Tachycardia Pulmonary Chest Pain Stenosis 74