article thumbnail

ECG Changes in Intracranial Hemorrhage

All About Cardiovascular System and Disorders

Mechanism is thought to be due to sustained sympathetic stimulation, probably caused by dysfunction of insular cortex resulting in reversible neurogenic damage to the myocardium which could include contraction bands and subendocardial ischemia [2]. 2009 Nov;40(11):3478-84. Epub 2009 Aug 27. doi: 10.1161/STROKEAHA.109.556753.

article thumbnail

No, we can’t call OMT, as a re-vascularisation  procedure.

Dr. S. Venkatesan MD

Reference : Apart from the heavily quoted classics of COURAGE, BARI-2D, ISCHEMIA, ORBITA 1 etc. Regular exercise equivalent to PCI (ESC 2009).Will Please note ORBITA -2 is not an antidote to ORBITA-1) ,Read this 1.AVERT AVERT study :Atorvastatin equals PCI.2.Regular Will try to get the link for this soon.

Plaque 59
article thumbnail

Fractional flow reserve for guiding coronary intervention and functional SYNTAX score

All About Cardiovascular System and Disorders

indicates inducible ischemia while an FFR above 0.80 excludes ischemia in 90% of cases. There is a strong correlation between FFR and inducible myocardial ischemia. It recalculates SYNTAX score by incorporating ischemia producing lesions determined by FFR. 2009 Jan 15;360(3):213-24. Normal FFR is 1.0 N Engl J Med.

article thumbnail

Physical Examination as a Helpful Aid in Decision-Making in Challenging ECGs

Dr. Smith's ECG Blog

Learning Point: Concordant ST segment elevation can arise from profound ischemia triggered by ventricular tachycardia (VT), or it may represent an exaggerated basal ST change accompanying tachycardia. The patient rapidly regained consciousness, reporting no residual pain. A peak troponin level of 70 ng/L was observed.

article thumbnail

Which patient has the more severe chest pain?

Dr. Smith's ECG Blog

Chest Pain Severity Rating Is a Poor Predictive Tool in the Diagnosis of ST-Segment Elevation Myocardial Infarction [link] Abstract Current ST-segment elevation myocardial infarction (STEMI) guidelines require persistent electrocardiogram ST-segment elevation, cardiac enzyme changes, and symptoms of myocardial ischemia.

article thumbnail

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

Dr. Smith's ECG Blog

DISCUSSION: The 12-lead EKG EMS initially obtained for this patient showed severe ischemia, with profound "infero-lateral" ST depression and reciprocal ST elevation in lead aVR. The ECG cannot diagnose the etiology of ischemia; it only the presence of ischemia, from whatever etiology. NEJM 362(9):779; March 4, 2009.

article thumbnail

Abstract WP176: Hemoglobin Decrement is Associated With Ischemic Lesions on Brain MRI of Patients With Acute Intracerebral Hemorrhage

Stroke Journal

Though this association may be related to impaired cerebral oxygen delivery, it is unclear whether these changes relate to cerebral ischemia. Patients who had a brain MRI and serial hemoglobin measurements were included.