Remove Cardiogenic Shock Remove Myocardial Infarction Remove Ultrasound
article thumbnail

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

DAIC

ET Main Tent (Hall B1) - A Double-blind, Randomized Placebo Procedure-controlled Trial of an Interatrial Shunt in Patients with HFrEF and HFpEF: Principal Results From the RELIEVE-HF Trial - Empagliflozin After Acute Myocardial Infarction: Results of the EMPACT-MI Trial - CSL112 (Apolipoprotein A-I) Infusions and Cardiovascular Outcomes in Patients (..)

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

Case continued A bedside ultrasound showed diminished LV EF and of course bradycardia. RVMI explains part of the shock. Literature cited In inferior myocardial infarction, neither ST elevation in lead V1 nor ST depression in lead I are reliable findings for the diagnosis of right ventricular infarction Johanna E.

article thumbnail

Diffuse Subendocardial Ischemia on the ECG. Left main? 3-vessel disease? No!

Dr. Smith's ECG Blog

Smith comment: This patient did not have a bedside ultrasound. Had one been done, it would have shown a feature that is apparent on this ultrasound (however, this patient's LV function would not be as good as in this clip): This is recorded with the LV on the right. In fact, bedside ultrasound might even find severe aortic stenosis.

article thumbnail

Chest Pain and Inferior ST Elevation.

Dr. Smith's ECG Blog

I have always said that tachycardia should argue against acute MI unless there is cardiogenic shock or 2 simultaneous pathologies. The goal of the present analysis was to examine whether the presence of tachycardia identified patients unlikely to have type 1 myocardial infarction.

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. A emergent cardiology consult can be helpful for equivocal cases. Left main?

article thumbnail

A young peripartum woman with Chest Pain

Dr. Smith's ECG Blog

Often, intravascular ultrasound or intravascular optical coherence tomography is requeried to make the diagnosis. were pretty sick, with mostly LM/pLAD lesions and high rates of cardiogenic shock. Revascularization in Patients With Spontaneous Coronary Artery Dissection and ST-Segment Elevation Myocardial Infarction.

article thumbnail

Subacute AnteroSeptal STEMI, With Persistent ST elevation and Upright T-waves

Dr. Smith's ECG Blog

ng/ml and was falling, confirming infarction days ago. Case Continued 2 days later the patient became increasingly tachycardic, hypotensive, ashen, clammy (in cardiogenic shock) and had a new murmur. If detected early by ultrasound, the patient can be saved. The initial troponin I was 23.7 This was the 12-lead ECG.

STEMI 52