14 results
Inpatient Cath Lab Indications
Cath Lab ASAP:
STEMI
NSTEMI:
1. Unstable/cardiogenic shock
2. Severe LV dysfunction or
3. Recurrent/persistent rest angina despite
Cath Lab ASAP: STEMI ... Unstable/cardiogenic ... shock 2. ... New/worsening MR ... low (1-2) risk, +ECG
DETROIT CARDIOGENIC SHOCK INITIATIVE ALGORITHM

INCLUSION CRITERIA
Acute Myocardial Infarction
 Ischemic Symptoms
 EKG and/or biomarker evidence of AMI
Ischemic Symptoms  EKG ... evidence of AMI (STEMI ... or NSTEMI) Cardiogenic ... TIMI III flow in all ... Initiative #Management #Cardiology
Severe Heart Failure & Cardiogenic Shock - Management Checklist 
Evaluation 
 - EKG & echocardiography
Evaluation - EKG ... treatment for acute MI ... Nephrotoxins (e.g ... channel blocker (eg ... #CHF #Shock #Cardiogenic
Approach to ECGs - Ischemia
MI = Biomarkers + ECG or echo/angiogram findings
Pathologic Q - 1/3 height
= Biomarkers + ECG ... Equivalents / Don't Miss Signs ... #Ischemia #ECG ... #EKG #diagnosis ... Interpretation #differential
Left Main Coronary Artery Thrombus seen on Angiography

“Mother of all coronary thrombi”.  55 year old
“Mother of all ... Anterior wall STEMI ... , in Cardiogenic ... shock, ECG predicted ... CathLab #clinical #cardiology
Right Heart Catheterization - Pulmonary Artery Pressures and Calculations
PULMONARY VASCULAR RESISTANCE = (meanPAP-PCWP) / CO
 •
Pressures and Calculations ... mortality in inferior MI ... RV dysfunction. e.g ... forward flow. e.g ... Ahmed Ghoneem, MD MSc
Pulmonary Embolism on POCUS Echocardiogram

Mid 30's female with chest pain/dyspnea.  Triage EKG (no prior).
Triage EKG (no prior ... Sister had MI in ... Differential/diagnosis ... RV, McConnell's sign ... A4c #clinical #cardiology
STEMI Equivalents on ECG
 • Conventional STEMI - Elevation of ST segment at (or 40-60 ms
on ECG • Conventional ... segment at (or 40-60 ms ... #Equivalents #ECG ... #EKG #diagnosis ... #differential #
Shock - Diagnosis and Management Summary
 • Hypotension: SBP<90, SBP drop >40, MAP<65 (Normotension, HTN possible
Full Set of Vital Signs ... telemetry, 12-Lead EKG ... Tamponade - Pulmonary ... resuscitation • Cardiogenic ... Shock - MI
Peripartum Cardiomyopathy - Summary
1. Definition
 • Towards the end of pregnancy to 5 months postpartum
Differential Diagnosis ... cardiomyopathy (e.g ... hemodynamics (e.g ... LVEF recovery (e.g ... teratogenic GDMT meds (e.g