2014 Ischemia Stent 
Dr. Smith's ECG Blog
APRIL 18, 2024
Written by Jesse McLaren A 70 year old with prior MIs and stents to LAD and RCA presented to the emergency department with 2 weeks of increasing exertional chest pain radiating to the left arm, associated with nausea. 2014 AHA/ACC guideline for the management of patients with non-ST elevation acute coronary syndromes. Amsterdam et al.
Dr. Smith's ECG Blog
DECEMBER 27, 2023
The pain will resolve and you will think the ischemia is gone when it is only hidden ! The note also says "slight lateral ST elevations noted, likely early repolarization since unchanged compared to 2014." Just before 10 AM, the patient received a stent to the culprit OM. Peak troponin was 12 ng/mL.
Dr. Smith's ECG Blog
JANUARY 3, 2022
It was a 60yo with a history of stents to the circumflex and right coronary arteries, who presented with 9 hours of fluctuating central chest pain. 2] Here there is no posterior ST elevation, but the anterior ST depression is also less—so it is dynamic, confirming acute ischemia. But it is still STEMI negative.
Dr. Smith's ECG Blog
OCTOBER 24, 2018
It was stented. This was clearly severe subepicardial ischemia causing ST Elevation, but it was not of a long enough duration to result in measurable infarct. It appears that on occasion — J waves may be induced by ischemia ( thought to reflect an acute injury current from impending myocardial infarction ). There was good flow.
Dr. Smith's ECG Blog
MARCH 9, 2025
It is not clear by her note what she meant by this (whether or not she recognized this EKG as diagnostic of transmural ischemia, and if so, of what territory) but emergent reperfusion therapy was not pursued. The proximal and mid LAD stenoses were stented and the OM 2 was left alone. Subendocardial ischemia does not localize.
Dr. Smith's ECG Blog
MARCH 8, 2025
After stent deployment, we often see improvement in the ST-T within seconds or minutes. Here is the final angiogram following placement of a stent in the ostial RCA. 2:04 PM, post stent deployment You can see that even after complete restoration of flow, the ECG still looks terrible, V most of all. link] Bentzon, J.
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