article thumbnail

Interplay between mitochondrial dysfunction and lysosomal storage: challenges in genetic metabolic muscle diseases with a focus on infantile onset Pompe disease

Frontiers in Cardiovascular Medicine

Background Pompe disease (PD) is a rare, progressive autosomal recessive lysosomal storage disorder that directly impacts mitochondrial function, leading to structural abnormalities and potentially culminating in heart failure or cardiogenic shock.

article thumbnail

Chest pain and shock: Is there a right ventricular OMI on this ECG? And should he undergo trancutaneous pacing?

Dr. Smith's ECG Blog

A 12-lead electrocardiogram, lead V4R , and leads V7-9 were recorded on admission. However, the impact of left ventricular posterior wall involvement (PWI) on the relation between ST upward arrow V4R and RVI is unknown. RVI was defined as occlusion proximal to the first major right ventricular branch of the RCA.

article thumbnail

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

New insights into the use of the 12-lead electrocardiogram for diagnosing acute myocardial infarction in the emergency department. An elderly man with sudden cardiogenic shock, diffuse ST depressions, and STE in aVR Literature 1. Harhash AA, Huang JJ, Reddy S, et al. aVR ST segment elevation: acute STEMI or not? Left main?

article thumbnail

How does Acute Total Left Main Coronary occlusion present on the ECG?

Dr. Smith's ECG Blog

At the bottom of the post, I have re-printed the section on aVR in my article on the ECG in ACS from the Canadian Journal of Cardiology: New Insights Into the Use of the 12-Lead Electrocardiogram for Diagnosing Acute Myocardial Infarction in the Emergency Department Case 1. Updates on the Electrocardiogram in Acute Coronary Syndromes.

article thumbnail

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

Dr. Smith's ECG Blog

Impella (cardiac output augmentation device) placed for cardiogenic shock Unfortunately, the patient progressed to multiorgan failure with worsening cardiac output despite being maxed on pressors and a balloon pump. He expired 4 days later. Interestingly, this patient was seen in the ED for hypertension and headache 3 days earlier.

article thumbnail

Should Troponin be a Vital Sign? Perhaps, but only if Interpreted Using Pre-test Probability.

Dr. Smith's ECG Blog

The patient went into cardiogenic shock and ultimately died of this MI. Across both selected patient populations, the positive predictive value was highest in patients with chest pain, with ischaemia on the electrocardiogram, and with a history of ischaemic heart disease. Regional WMA: Lateral , large, hypokinetic.