Dr. Smith's ECG Blog

OCTOBER 20, 2024

The first task when assessing a wide complex QRS for ischemia is to identify the end of the QRS. The ST segment changes are compatible with severe subendocardial ischemia which can be caused by type I MI from ACS or potentially from type II MI (non-obstructive coronary artery disease with supply/demand mismatch). What do you think?

Cardiogenic Shock 128

Cardiogenic Shock Ischemia Chest Pain Cardiac Arrest 128

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

DISCUSSION: The 12-lead EKG EMS initially obtained for this patient showed severe ischemia, with profound "infero-lateral" ST depression and reciprocal ST elevation in lead aVR. The ECG cannot diagnose the etiology of ischemia; it only the presence of ischemia, from whatever etiology.

Ischemia 40

Ischemia Cardiogenic Shock Aortic Stenosis 40

DAIC

FEBRUARY 29, 2024

ET Murphy Ballroom 4 Comparison of an "Inclisiran First" Strategy with Usual Care in Patients With Atherosclerotic Cardiovascular Disease: Results From the VICTORION-INITIATE Randomized Trial Targeting Weight Loss to Personalize the Prevention of Type 2 Diabetes Once-weekly Semaglutide in Patients with Heart Failure With Preserved Ejection Fraction, (..)

Aortic valve 103

Aortic valve Myocardial Infarction Aortic Blood Pressure 103

Dr. Smith's ECG Blog

JUNE 11, 2021

Accordingly, in the algorithm by Cai et al for patients with LBBB and ischemic symptoms ( See below ) — the first indication for PCI is clinical: patients with hemodynamic instability or acute heart failure. So there is now high pre-test probability + refractory ischemia + Modified Sgarbossa + dynamic ECG changes.

Chest Pain 52

Chest Pain Cardiac Arrest Ischemia Cardiogenic Shock 52

DAIC

MARCH 25, 2024

Rapid Fire Challenging Structural Heart Imaging Cases with Heart Team Panel; Follow-up of Pacemakers and ICDS for the Non-electrophysiologist; The Real Reasons Your Patient with Heart Failure was Readmitted: Noncardiac Comorbidities, Geriatric Syndromes and Social Determinants of Health; and Death by a Thousand Cuts!

Education 59

Education Cardiogenic Shock Heart Failure Plaque 59

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. Eur Heart J Acute Cardiovasc Care [Internet] 2020;9(1):62–9. They recorded an EC G: New ST Elevation.

Cardiac Arrest 52

Cardiac Arrest COVID-19 Myocardial Infarction Cardiogenic Shock 52

Dr. Smith's ECG Blog

OCTOBER 6, 2023

All of this appears to be consistent with "No Reflow", or small vessel occlusion with persistent ischemia in spite of an open artery. His included cardiogenic shock, V Tach, AV block. --There is persistent ST elevation in leads V1-V4, with a lot of STE in V4 (another bad sign). Such large infarcts have many complications.

Aneurysm 66

Aneurysm Chest Pain Cardiogenic Shock Blog 66