Cardiogenic Shock and Diabetes - Cardiovascular Update

Why the sudden shock after a few days of malaise?

Dr. Smith's ECG Blog

SEPTEMBER 5, 2024

The VSR is what is causing the cardiogenic shock! Mechanical complications occur acutely and significantly alter hemodynamics leading to comp ensatory mechanism which usually involve vasoconstriction and tachycardia, both hallmarks of cardiogenic shock. PIRP is strongly associated with myocardial rupture.

Cardiogenic Shock

Cardiogenic Shock Chest Pain Pericarditis Myocardial Infarction

A more-Comers populAtion trEated with an ultrathin struts polimer-free Sirolimus stent: an Italian post-maRketing study (the CAESAR registry)

Frontiers in Cardiovascular Medicine

JANUARY 7, 2024

Patients with left main (LM) disease, cardiogenic shock (CS), or severely reduced left-ventricular ejection fraction (LVEF) were excluded. years, Diabetes mellitus 29%, acute coronary syndrome 67%, chronic total occlusion 9%). The primary endpoint was target-lesion revascularization (TLR) at 1 year.

Stents

Stents Stent Cardiogenic Shock Coronary Artery Disease

Transcatheter edge‐to‐edge repair in severe mitral regurgitation following acute myocardial infarction – aetiology‐based analysis

European Journal of Heart Failure

JANUARY 14, 2025

PMR patients had fewer cardiovascular risk factors: hypertension (52% vs. 73%, p =0.04), diabetes (26% vs. 48%, p <0.01) but a higher left ventricular ejection fraction (4515% vs.3510%, p <0.01) compared secondary MR patients. Aetiology of MR, cardiogenic shock, and procedure timing significantly impacted in-hospital mortality.

Myocardial Infarction

Myocardial Infarction Bicuspid/Mitral Cardiogenic Shock Risk Factors

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Bridging Innovation & Patient Care: The Growing Role of AI

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Prevalence and outcomes of patients with SMuRF-less acute coronary syndrome undergoing percutaneous coronary intervention

Open Heart

JUNE 5, 2024

Background There is increasing awareness that patients without standard modifiable risk factors (SMuRFs; diabetes, hypercholesterolaemia, hypertension and smoking) may represent a unique subset of patients with acute coronary syndrome (ACS). vs 50.8%, p<0.001) and were more likely to experience postprocedural cardiogenic shock (4.5%

Cardiogenic Shock

Cardiogenic Shock Myocardial Infarction Outcomes Coronary Artery Disease

Abstract WP294: Racial Disparities among the risk of Stroke and other clinical outcomes post Infective Endocarditis: A Propensity Matched Analysis

Stroke Journal

JANUARY 30, 2025

Propensity score-matched analysis (PSM) (1:1) was performed on age, gender, BMI, hypertension, diabetes mellitus, chronic kidney disease, hemoglobin level, LDL level, left ventricular ejection fraction and various drugs including beta blockers, ACEi and ARBi. 0.89), P<0.001), and after 1 year (RR, 0.91 (95% CI: 0.86-0.96),

Cardiogenic Shock

Cardiogenic Shock Stroke Strokes Outcomes

American College of Cardiology ACC.24 Late-breaking Science and Guidelines Session Summary

DAIC

FEBRUARY 29, 2024

12:15 p.m.

Aortic valve

Aortic valve Myocardial Infarction Aortic Blood Pressure

Outcomes of PCI of all comers: the experience of a Kuwaiti independent healthcare institution

The British Journal of Cardiology

APRIL 16, 2024

Comorbidities included dyslipidaemia 515/567 (90.9%), hypertension 460/567 (81.2%), diabetes 346/567 (61%), known prior coronary disease 250/567 (44.2%), and smoking 188/567 (33.1%). The radial approach was used in 544/567 (95.94%), the average SYNTAX score was 34.8 ± 9.6, and the average number of stents 2.6.

Outcomes

Outcomes Cardiogenic Shock Angina STEMI

Two patients with chest pain and RBBB: do either have occlusion MI?

Dr. Smith's ECG Blog

OCTOBER 17, 2024

Past medical history included diabetes and hypertension. As often emphasized by Dr. Smith — sinus tachycardia is not a common finding with acute OMI unless something else is going on (ie, cardiogenic shock ). CT chest showed left sided pulmonary embolism and a pulmonary infarct that had previously been mistaken for pneumonia.

Chest Pain

Chest Pain STEMI Pulmonary Embolism

A man in his 70s with chest pain

Dr. Smith's ECG Blog

NOVEMBER 23, 2022

He had history of prior MIs and CABG, as well as diabetes, hypertension, and hyperlipidemia. He was in cardiogenic shock requiring an impella for several days after cath. The pain was still ongoing at arrival. He also noted a bilateral "odd feeling" in his arms. He stated it was similar to prior heart attacks.

Chest Pain

Chest Pain Cardiac Arrest Cardiogenic Shock Heart Attack

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

NOVEMBER 4, 2022

Case submitted and written by Mazen El-Baba MD, with edits from Jesse McLaren and edits/comments by Smith and Grauer A 90-year old with a past medical history of atrial fibrillation, type-2 diabetes, hypertension, dyslipidemia, presented with acute onset chest/epigastric pain, nausea, and vomiting. BP was 110 and oxygen saturation was normal.

Ischemia

Ischemia STEMI Stenosis Chest Pain

See what happens when a left main thrombus evolves from subtotal occlusion to total occlusion.

Dr. Smith's ECG Blog

OCTOBER 20, 2024

Written by Magnus Nossen The patient in today's case is a male in his 70s with hypertension and type II diabetes mellitus. Figure B At this point, with the ECG changing from diffuse ST depression to widespread ST elevation and the patient presenting in cardiogenic shock, left main coronary artery (LMCA) occlusion is the likely diagnosis.

Cardiogenic Shock

Cardiogenic Shock Ischemia Chest Pain Cardiac Arrest

Impact of Anemia and Iron Deficiency on Outcomes in Cardiogenic Shock Complicating Acute Myocardial Infarction

European Journal of Heart Failure

DECEMBER 12, 2023

Abstract Objectives This study aimed to assess the impact of anemia and iron deficiency (ID) on clinical outcome in patients with cardiogenic shock (CS) complicating acute myocardial infarction (AMI).

Cardiogenic Shock

Cardiogenic Shock Myocardial Infarction Outcomes Catheterization Laboratory

Adherence to optimal medical therapy and control of cardiovascular risk factors in patients after ST elevation myocardial infarction in Mexico

Frontiers in Cardiovascular Medicine

JULY 22, 2024

years to monitor MACEs (cardiovascular death, cardiogenic shock, recurrent myocardial infarction, and heart failure).ResultsWe Hypertension (42.4%), smoking (34.3%), type 2 diabetes mellitus (31.2%), obesity (22.92%), and dyslipidemia (21.4%) were highly prevalent. Patients were followed up for 4.5

Myocardial Infarction

Myocardial Infarction Risk Factors Cardiogenic Shock STEMI

Impact of admission glucose and 30-day major adverse cardiovascular events on patients with chest pain in an emergency setting: insights from the China EMPACT registry

Frontiers in Cardiovascular Medicine

OCTOBER 8, 2024

The primary outcome was 30-day MACE, including all-cause death, recurrent myocardial infarction, urgent target vessel revascularization, stroke, cardiogenic shock, and cardiac arrest (CA). years, with 1,028 (60.29%) being male and 500 (29.33%) having diabetes. The average age of the patients was 65.23 ± 12.66 years,

Chest Pain

Chest Pain Cardiogenic Shock Cardiac Arrest Myocardial Infarction

Acute chest pain, right bundle branch block, no STEMI criteria, and negative initial troponin.

Dr. Smith's ECG Blog

SEPTEMBER 12, 2024

His history included known heart failure with prior EF 18%, insulin dependent diabetes, and polysubstance abuse. Smith : LAD OMI with RBBB/LAFB is not only subtle on the ECG, but most of these patients are extremely ill: most I have seen are post-ROSC, in cardiogenic shock, or arrested shortly after.

Chest Pain

Chest Pain STEMI Cardiogenic Shock Heart Failure

Extreme shock and cardiac arrest in COVID patient

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

Assessment was severe sudden cardiogenic shock. Higher troponin correlated with more history of heart failure, diabetes, and hypertension, as well as higher D-dimer, and nearly all inflammatory markers. Clinically — the patient was felt to be in cardiogenic shock. They recorded an EC G: New ST Elevation.

Cardiac Arrest

Cardiac Arrest COVID-19 Myocardial Infarction Cardiogenic Shock

Noisy, low amplitude ECG in a patient with chest pain

Dr. Smith's ECG Blog

JANUARY 15, 2024

A patient in their 40s with type 1 diabetes mellitus and hyperlipidemia presented to the emergency department with 5 days of “flu-like” illness. Tachycardia is unusual for OMI, unless the patient is in cardiogenic shock (or getting close). Edits by Willy Frick. We can see enough to make out that the rhythm is sinus tachycardia.

Chest Pain

Chest Pain Blog Arrhythmia Critical Care

A man in his 70s with acute chest pain and paced rhythm.

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. Sent by Pete McKenna M.D. Triage ECG: What do you think? This is diagnostic of proximal LAD occlusion. This is a huge anterolateral OMI.

Chest Pain

Chest Pain Myocardial Infarction STEMI Pacemaker

Published Research

Society of Thoracic Surgeons - Research

APRIL 20, 2023

Mark Erfe Outcomes of Sutureless/Rapid Deployment Valves Compared to Traditional Bioprosthetic Aortic Valves The Annals of Thoracic Surgery September 2020 J.

Research

Research Coronary Artery Bypass Graft Aortic valve Congenital

Published Research

Society of Thoracic Surgeons - Research

APRIL 20, 2023

Institutional Coronary Artery Bypass Case Volumes and Outcomes European Journal of Heart Failure October 2023 Makoto Mori 1 Robotic Mitral Valve Repair for Degenerative Mitral Regurgitation The Annals of Thoracic Surgery August 2023 Carlos Diaz-Castrillion 2 Volume-Failure to Rescue Relationship in Acute Type A Aortic Dissections: An Analysis of The (..)

Research

Research Coronary Artery Bypass Graft Aortic valve Congenital

The First 60 Minutes of a Heart Attack: The Golden Hour

Wellnest

JULY 19, 2023

However, recent studies have observed that people below 40 are also experiencing heart attacks due to high blood pressure, cholesterol, diabetes, smoking, obesity, a sedentary lifestyle, and social and mental stress. Manage diabetes. Diabetes increases the risk of diabetic heart disease by a factor of two.

Heart Attack

Heart Attack Heart attacks Blood Pressure Myocardial Infarction

Best of cardiology in 2024 : Check it out and find the winner.

Dr. S. Venkatesan MD

JANUARY 1, 2025

24) Microaxial Flow Pump in Infarct-Related Cardiogenic Shock DanGer Shock (ACC.24) 24 and TCT 2024) Colchicine in AMI CLEAR SYNERGY (OASIS 9) (TCT 2024 and AHA 2024) Semaglutide Treatment Effect in People With Obesity and HFpEF and Diabetes Mellitus STEP-HFpEF DM (ACC.24)

Cardiogenic Shock

Cardiogenic Shock Plaque Academic Bicuspid/Mitral

Why the sudden shock after a few days of malaise?

A more-Comers populAtion trEated with an ultrathin struts polimer-free Sirolimus stent: an Italian post-maRketing study (the CAESAR registry)

Transcatheter edge‐to‐edge repair in severe mitral regurgitation following acute myocardial infarction – aetiology‐based analysis

Webinars

Prevalence and outcomes of patients with SMuRF-less acute coronary syndrome undergoing percutaneous coronary intervention

Abstract WP294: Racial Disparities among the risk of Stroke and other clinical outcomes post Infective Endocarditis: A Propensity Matched Analysis

American College of Cardiology ACC.24 Late-breaking Science and Guidelines Session Summary

Outcomes of PCI of all comers: the experience of a Kuwaiti independent healthcare institution

Two patients with chest pain and RBBB: do either have occlusion MI?

A man in his 70s with chest pain

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

See what happens when a left main thrombus evolves from subtotal occlusion to total occlusion.

Impact of Anemia and Iron Deficiency on Outcomes in Cardiogenic Shock Complicating Acute Myocardial Infarction

Adherence to optimal medical therapy and control of cardiovascular risk factors in patients after ST elevation myocardial infarction in Mexico

Impact of admission glucose and 30-day major adverse cardiovascular events on patients with chest pain in an emergency setting: insights from the China EMPACT registry

Acute chest pain, right bundle branch block, no STEMI criteria, and negative initial troponin.

Extreme shock and cardiac arrest in COVID patient

Noisy, low amplitude ECG in a patient with chest pain

A man in his 70s with acute chest pain and paced rhythm.

Published Research

Published Research

The First 60 Minutes of a Heart Attack: The Golden Hour

Best of cardiology in 2024 : Check it out and find the winner.

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