Remove Cardiogenic Shock Remove Critical Care Remove Tachycardia
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Tachycardia must make you doubt an ACS or STEMI diagnosis; put it all in clinical context

Dr. Smith's ECG Blog

He was rushed by residents into our critical care room with a diagnosis of STEMI, and they handed me this ECG: There is sinus tachycardia with ST elevation in II, III, and aVF, as well as V4-V6. ACS and STEMI generally do not cause tachycardia unless there is cardiogenic shock. He had this ECG recorded.

STEMI 52
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Chest discomfort, Sinus Tachycardia, Q-waves, ST Elevation, and Intermittent Wide Complex Tachycardia. Activate the Cath Lab?

Dr. Smith's ECG Blog

Because of the tachcardia, I would expect her to be very poor left ventricular function and maybe Cardiogenic shock. Still Irregular Blood pressure during these rhythms was adequate; there was no shock. The patient spontaneously converted back to sinus tachycardia. Later, I obtained more clinical history.

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Noisy, low amplitude ECG in a patient with chest pain

Dr. Smith's ECG Blog

Colin is an emergency medicine resident beginning his critical care fellowship in the summer with a strong interest in the role of ECG in critical care and OMI. We can see enough to make out that the rhythm is sinus tachycardia. Written by Colin Jenkins. Edits by Willy Frick.

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A 40-Something male with a "Seizure," Hypotension, and Bradycardia

Dr. Smith's ECG Blog

Why is the patient in shock? He was in profound cardiogenic shock. Both of these features make inferior + RV MI by far the most likely ( Pseudoanteroseptal MI is another name for this ) There is also sinus bradycardia and t he patient is in shock with hypotension. There is an obvious inferior STEMI, but what else?