Dr. Smith's ECG Blog

MARCH 30, 2014

Then the notes mention "cardiogenic shock" but without any reference to a cardiac echo or to a chest x-ray. Outcome and Analysis: ECG 1 is diagnostic of inferior and right ventricular MI. This is the etiology of the syncope and hypotension and shock and elevated CVP. Was there pulmonary edema? What was the diagnosis?

Outcomes 52

Outcomes Cardiogenic Shock STEMI Chest Pain 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

His response: “subendocardial ischemia. Smith : It should be noted that, in subendocardial ischemia, in contrast to OMI, absence of wall motion abnormality is common. With the history of Afib, CTA abdomen was ordered to r/o mesenteric ischemia vs ischemic colitis vs small bowel obstruction. Anything more on history?

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52

Dr. Smith's ECG Blog

SEPTEMBER 17, 2023

There is normal R-wave progression in the precordial leads with no evidence of ischemia. Here the image quality is enhanced using the PM Cardio app. What do you think? The presenting ECG shows SR with narrow QRS complexes. In the limb leads there is T-wave inversion in lead aVL with a low amplitude QRS preceding the T-wave.

Pulmonary 116

Pulmonary Tricuspid Chest Pain Cardiogenic Shock 116

Dr. Smith's ECG Blog

AUGUST 9, 2019

Post by Smith and Meyers Sam Ghali ( [link] ) just asked me (Smith): "Steve, do left main coronary artery *occlusions* (actual ones with transmural ischemia) have ST Depression or ST Elevation in aVR?" That said, complete LM occlusion would be expected to have subepicardial ischemia (STE) in these myocardial territories: STE vector 1.

Myocardial Infarction 52

Myocardial Infarction Ischemia STEMI Cardiogenic Shock 52

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

Assessment was severe sudden cardiogenic shock. However, in multiple studies, even in the absence of AMI, both acute and chronic myocardial injury (as diagnosed by any elevated cTn) are powerful markers of adverse outcomes in both the short and long term. Clinically — the patient was felt to be in cardiogenic shock.

Cardiac Arrest 52

Cardiac Arrest COVID-19 Myocardial Infarction Cardiogenic Shock 52

DAIC

MARCH 25, 2024

We aim to improve global care outcomes through the distribution of educational materials to clinicians in underserved communities worldwide,” Drachman continued. Session 510) To Treat or Not to Treat Anatomy and Ischemia? Session 508) Battle of the Imagers - Jeopardy Edition!

Education 59

Education Cardiogenic Shock Heart Failure Plaque 59

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. Thus, this ECG predicts poor myocardial perfusion and poor outcome. His included cardiogenic shock, V Tach, AV block. Such large infarcts have many complications.

Aneurysm 66

Aneurysm Chest Pain Cardiogenic Shock Blog 66

Dr. Smith's ECG Blog

MAY 8, 2023

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. EKG shown here: LAFB with no clear signs of OMI or ischemia. He expired 4 days later.

Chest Pain 52

Chest Pain Myocardial Infarction STEMI Pacemaker 52

Dr. Smith's ECG Blog

OCTOBER 24, 2019

This strongly suggests reperfusing RCA ischemia. Troponins, echocardiogram An echocardiogram showed inferobasilar hypokinesis, further supporting a diagnosis of regional ischemia , likely of the area supplied by the RCA. were pretty sick, with mostly LM/pLAD lesions and high rates of cardiogenic shock. Lobo et al.

Chest Pain 52

Chest Pain SCAD STEMI Cardiogenic Shock 52

Dr. Smith's ECG Blog

FEBRUARY 5, 2019

The patient went into cardiogenic shock and ultimately died of this MI. Main outcome measures Positive predictive value of an elevated cardiac troponin concentration for a diagnosis of type 1 myocardial infarction. Regional WMA: Lateral , large, hypokinetic.

Myocardial Infarction 52

Myocardial Infarction Chest Pain Cardiogenic Shock STEMI 52

Dr. Smith's ECG Blog

MARCH 25, 2025

There is low voltage in the precordium which always makes reading ischemia harder. In ACS, chest pain is the warning sign of ongoing ischemia. Smith : As Willy says, and as we've said many times before, morphine will resolve pain without resolving ischemia. ECG 1 What do you think? To me, this ECG is not diagnostic.

Chest Pain 63

Chest Pain Ischemia Plaque Stents 63

Dr. Smith's ECG Blog

MARCH 3, 2025

Whenever there is tachycardia, I am skeptical of OMI unless it has led to severely compromised ejection fracction with cardiogenic shock. The patient was started on heparin for possible NSTEMI vs demand ischemia. increasing stenosis, ischemia, volume changes, increased blood pressure, atrial fibrillation, etc.)

Tachycardia 74

Tachycardia Pulmonary Chest Pain Stenosis 74