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PEARL # 2: In the absence of associated heart failure ( cardiogenicshock ) — sinus tachycardia is not a common finding in acute MI. For a 10-minute video review on reading Pulmonary CT Scan — WATCH_this_VIDEO by Dr. Jake Gibbons. For now — Let's continue with ECG signs consistent with and suggestive of acute RV "Strain".
One of my most talented readers is a health care assistant (a nursing assistant) who has taken a keen interest in ECGs. Then the notes mention "cardiogenicshock" but without any reference to a cardiac echo or to a chest x-ray. Was there pulmonary edema? And they teach me a lot. He can beat nearly anyone.
Chest X-ray also showed pulmonary edema. 1) as far as I can tell, there is very little data on amiodarone for this indication 2) amiodarone has beta blockade effects which could be deleterious in a patient with large anterior MI with pulmonary edema and at risk for cardiogenicshock (and she did go into shock.
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