Cardiogenic Shock Pulmonary Ultrasound 
Dr. Smith's ECG Blog
SEPTEMBER 23, 2024
Taking a step back , remember that sinus tachycardia is less commonly seen in OMI (except in cases of impending cardiogenic shock). In patients with narrow QRS ( not this patient), this pattern is highly suggestive of acute pulmonary embolism. Answer : Bedside ultrasound! So CT is required to find the diagnosis!
Frontiers in Cardiovascular Medicine
FEBRUARY 19, 2024
Background Pompe disease (PD) is a rare, progressive autosomal recessive lysosomal storage disorder that directly impacts mitochondrial function, leading to structural abnormalities and potentially culminating in heart failure or cardiogenic shock. Further genetic testing identified a homozygous mutation c.2662G>T
Dr. Smith's ECG Blog
NOVEMBER 19, 2016
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.
Dr. Smith's ECG Blog
OCTOBER 17, 2024
Smith comment: before reading anything else, this case screamed pulmonary embolism to me. I would do bedside ultrasound to look at the RV, look for B lines as a cause of hypoxia (which would support OMI, and argue against PE), and if any doubt persists, a rapid CT pulmonary angiogram. There is sinus tachycardia at ~100/minute.
Dr. Smith's ECG Blog
JULY 18, 2014
Case Continued 2 days later the patient became increasingly tachycardic, hypotensive, ashen, clammy (in cardiogenic shock) and had a new murmur. Rupture can be either free wall rupture (causing tamonade) or septal rupture, causing ventricular septal defect with left to right flow and resulting pulmonary edema and shock.
Dr. Smith's ECG Blog
JUNE 17, 2018
I have always said that tachycardia should argue against acute MI unless there is cardiogenic shock or 2 simultaneous pathologies. While sensitivity of this sign is very low — its presence is highly suggestive of longstanding and severe pulmonary disease. We showed this in a recent analysis of UTROPIA data (see abstract below).
Dr. Smith's ECG Blog
NOVEMBER 12, 2020
A bedside cardiac ultrasound was normal, with no effusion. Assessment was severe sudden cardiogenic shock. and the patient was converted to veno-venous (V-V) ECMO due to persistent pulmonary insufficiency. Clinically — the patient was felt to be in cardiogenic shock. They recorded an EC G: New ST Elevation.
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