Remove 2013 Remove Cardiogenic Shock Remove Stenosis
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Diffuse Subendocardial Ischemia on the ECG. Left main? 3-vessel disease? No!

Dr. Smith's ECG Blog

A transthoracic echocardiogram showed an LV EF of less than 15%, critically severe aortic stenosis , severe LVH , and a small LV cavity. The aortic valve in this example also had critical stenosis by Doppler The patient continued to be hemodynamically unstable with poor cardiac output and very high LV filling pressures.

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90 year old with acute chest and epigastric pain, and diffuse ST depression with reciprocal STE in aVR: activate the cath lab?

Dr. Smith's ECG Blog

History sounds concerning for ACS (could be critical stenosis, triple vessel), but differential also includes dissection, GI bleed, etc. 2 cases of Aortic Stenosis: Diffuse Subendocardial Ischemia on the ECG. An elderly man with sudden cardiogenic shock, diffuse ST depressions, and STE in aVR Literature 1. Left main?

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How does Acute Total Left Main Coronary occlusion present on the ECG?

Dr. Smith's ECG Blog

7) The 2013 ACC/AHA STEMI guidelines consider this a “STEMI equivalent,” where thrombolytic therapy is not contraindicated (Evidence level B, no specific class of recommendation).(16) baseline LVH, demand ischemia secondary to respiratory failure, aortic stenosis, hemorrhagic shock). TIMI 0/1 flow).(61,62) Knotts et al.

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A man in his 70s with acute chest pain and paced rhythm.

Dr. Smith's ECG Blog

So the patient was taken for emergent cath, showing: Culprit artery: LAD (100% stenosis, TIMI 0) requiring thrombectomy and stent. Queen of Hearts interpretation: Now the cardiologist considered it "STEMI"!