Cardiogenic Shock Hypertension Physiology 
Dr. Smith's ECG Blog
NOVEMBER 19, 2016
It was edited by Smith CASE : A 52-year-old male with a past medical history of hypertension and COPD summoned EMS with complaints of chest pain, weakness and nausea. Authors' commentary: Cardiogenic shock in the setting of severe aortic stenosis. Fundamentally, cardiogenic shock is an issue of decreased cardiac output.
Dr. Smith's ECG Blog
MARCH 12, 2018
This includes, but is not limited to, PE, asthma/COPD exacerbation, hypoxic vasoconstriction from pneumonia, acute pulmonary hypertension exacerbation. When there is tachycardia, the patient is in cardiogenic shock with very poor LV function on bedside echo. The T-waves simply look different in Wellens'.
Dr. Smith's ECG Blog
FEBRUARY 28, 2020
My answer: "This is classic for PE, but it can also be present in any hypoxia due pulmonary hypoxic vasoconstriction and resulting acute pulmonary hypertension and acute right heart strain. Tachycardia is unusual in ACS unless there is cardiogenic shock or a second simultaneous pathology. This is NOT Wellens. The answer was yes.
Dr. Smith's ECG Blog
NOVEMBER 26, 2018
He was hypertensive and tachycardic, with mildly increased work of breathing. The axiom of "type 1 (ACS, plaque rupture) STEMIs are not tachycardic unless they are in cardiogenic shock" is not applicable outside of sinus rhythm. Here is his initial ECG: What do you think? What will you do for this patient?
Dr. S. Venkatesan MD
APRIL 11, 2025
I don’t know whether I can say Yes*, physiologically, the high proximal pressure and low distal pressure help maintain the flow. Mind you, IABP during cardiogenic shock, essentially does this – keep the coroanry diastolic pressure high. H owever, there are significant caveats.
Expert insights. Personalized for you.
40 
Let's personalize your content