How is the dx of a CS?

Clinical (dyspnea, paleness, altered mental status, weak rapid pulse, or bradycardia due to high-grade heart block, hypotension with narrow PP, tachypnea, cheyen-stokes respirations, jugular vein distention, oligouria (maybe) Labs (leukocytosis (left shift), urea and creatinine rise, liver hypoperfusion elevates liver proteins, lactic acid elevated, ABG (hypoxemia and acidosis, maybe compensated by respiratory alkalosis), cardiac markers (CPK, MB, Troponin I and T elevated)) ECG (Anterior infarct (more than half), ST depression (left main stenosis cause), AMI with LV failure (Q wave / ST elevation, LBBB) CXR (pulmonary vascular congestion and pulmonary edema (only third of pts), normal Heart size (may be enlarged in first MI) TTE (sees severity and dx (shunts, PE, dissection) Left heart catheter (may be done))