2009 and Ischemia - Cardiovascular Update

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

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

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.

Ischemia

Ischemia Cardiogenic Shock Aortic Stenosis

ECG Changes in Intracranial Hemorrhage

All About Cardiovascular System and Disorders

NOVEMBER 16, 2023

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.

Hemorrhage

Hemorrhage Myocardial Infarction Aneurysm Electrocardiogram

Precordial ST depression. What is the diagnosis?

Dr. Smith's ECG Blog

JANUARY 1, 2013

Precordial ST depression may be subendocardial ischemia or posterior STEMI. I have warned in the past that one must think of other etiologies of ischemia when there is tachycardia. Whether it is subendocardial ischemia or posterior STEMI, if you cannot get it to resolve, you must activate the cath lab. There is no ST elevation.

STEMI

STEMI Ischemia Chest Pain Myocardial Infarction

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Bridging Innovation & Patient Care: The Growing Role of AI

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

Dr. Smith's ECG Blog

JANUARY 1, 2024

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.

Tachycardia

Tachycardia Blog Heart Failure Ischemia

Abstract WMP115: Towards a Comprehensive Computational Model of Ischemic Stroke: Integrating Detailed Microvasculature With Advanced Model of Brain Tissue Metabolism

Stroke Journal

JANUARY 30, 2025

Results:Figure 2 shows timecourse of GLC, ATP, and Sodium in different compartments of the model through time in regions experiencing mild and severe ischemia. 2009 Dec 1;27(3):391 A physiologically accurate in silico model would provide a new route for study of the response to an ischemic event. T Ventimiglia et al. 2023;39:e37353.

Stroke

Stroke Strokes Physiology Ischemia

Which patient has the more severe chest pain?

Dr. Smith's ECG Blog

SEPTEMBER 26, 2023

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.

Chest Pain

Chest Pain STEMI Myocardial Infarction Electrocardiogram

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

Dr. S. Venkatesan MD

FEBRUARY 25, 2024

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.

Chest Pain

Chest Pain Plaque Stents Stent

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

Stroke Journal

FEBRUARY 1, 2024

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.

Hemorrhage

Hemorrhage Blood Pressure Ischemia Hospital

Abstract WP173: Major ABO Incompatible Platelet Transfusion is Associated With Ischemic Lesions on Brain MRI of Patients With Intracerebral Hemorrhage

Stroke Journal

FEBRUARY 1, 2024

We explored whether major ABO incompatible platelet transfusions are associated with these ischemic lesions.Methods:Consecutive spontaneous ICH patients enrolled into a single-center, prospective cohort study between 2009 and 2016 were assessed. Major ABO incompatible platelet transfusion was the exposure. 217.94, p = 0.03).Conclusions:Major

Hemorrhage

Hemorrhage Ischemia Risk Factors Outcomes

Fractional flow reserve for guiding coronary intervention and functional SYNTAX score

All About Cardiovascular System and Disorders

APRIL 21, 2024

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.

Myocardial Infarction

Myocardial Infarction Stents Stent Coronary Artery Disease

Middle Aged Woman with Asystolic Cardiac Arrest, Resuscitated: Cath Lab?

Dr. Smith's ECG Blog

OCTOBER 20, 2013

This ECG is diagnostic of diffuse subendocardial ischemia. Methods: Between June 2007 - July 2009 all NT-OHCA patients aged >18, transported to our hospital, an urban, level one trauma teaching hospital were included. Chicago November 2010.

Cardiac Arrest

Cardiac Arrest STEMI Hemorrhage Hospital

Target Acquired

EMS 12-Lead

APRIL 2, 2022

Diagnosis of left ventricular hypertrophy in the presence of left anterior fascicular block: A reexamination of the 2009 AHA/ACC/HRS guidelines. Grauer's great explanations on -- LAFB [link] RBBB-LBBB-IVCD [link] LBBB-Sgarbossa-LVH-MI [link] [1] Ravi, S., Annals of Noninvasive Electrocardiology, 18 (1), 21-28. [2] 2] Surawicz, B.

Myocardial Infarction

Myocardial Infarction Stent Stents STEMI

Abstract WP26: Determinants of Neuropsychological Function after Aneurysmal Subarachnoid Hemorrhage

Stroke Journal

JANUARY 30, 2025

This study aimed to analyze the clinical variables associated with the neuropsychological function in a large cohort of aSAH survivors.Methods:Patients with aSAH admitted to our institution since 2009 were recruited. and in patients who developed new radiological ischemia during hospitalization (OR: 3.42, p 0.03).

Hemorrhage

Hemorrhage Aneurysm Quality of Life Ischemia

Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.

Dr. Smith's ECG Blog

APRIL 8, 2015

Evidence of acute ischemia (may be subtle) vii. in 2010 EM Clinics of North America (full text link) For an Exhaustive Review of Syncope and its full management outside the ED environment, go to the 2009 European Society of Cardiology Guidelines (full text pdf). Arch Intern Med 2009 Jul 27; 169:1262. Left BBB vi. LVH or RV d.

Arrhythmia

Arrhythmia Outcomes Risk Factors Chest Pain

Surgical outcomes in adolescents and adults with anomalous aortic origin of a coronary artery

Frontiers in Cardiovascular Medicine

NOVEMBER 21, 2024

BackgroundAnomalous aortic origin of a coronary artery (AAOCA) is associated with an increased risk of myocardial ischemia and sudden cardiac death. ResultsThe median age at surgery was 26 years (range, 13–57 years). ResultsThe median age at surgery was 26 years (range, 13–57 years).

Aortic

Aortic Sudden Cardiac Death Angioplasty Outcomes

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

ECG Changes in Intracranial Hemorrhage

Precordial ST depression. What is the diagnosis?

Webinars

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

Abstract WMP115: Towards a Comprehensive Computational Model of Ischemic Stroke: Integrating Detailed Microvasculature With Advanced Model of Brain Tissue Metabolism

Which patient has the more severe chest pain?

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

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

Abstract WP173: Major ABO Incompatible Platelet Transfusion is Associated With Ischemic Lesions on Brain MRI of Patients With Intracerebral Hemorrhage

Fractional flow reserve for guiding coronary intervention and functional SYNTAX score

Middle Aged Woman with Asystolic Cardiac Arrest, Resuscitated: Cath Lab?

Target Acquired

Abstract WP26: Determinants of Neuropsychological Function after Aneurysmal Subarachnoid Hemorrhage

Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.

Surgical outcomes in adolescents and adults with anomalous aortic origin of a coronary artery

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