2017, Circulation and Ischemia - Cardiovascular Update

Update on Diagnosis and Management of Kawasaki Disease: A Scientific Statement From the American Heart Association

Circulation

NOVEMBER 13, 2024

Circulation, Ahead of Print. This update summarizes relevant clinical data published since the 2017 American Heart Association scientific statement on KD related to diagnosis, cardiac imaging in acute KD treatment, and long-term management.

Aneurysm

Aneurysm Myocardial Infarction Cardiovascular Imaging Ischemia

HeartFlow Announces Revolutionary Five-Year Data Demonstrating a 63 Percent Mortality Reduction with FFRCT-Guided Care in PAD Patients

DAIC

MAY 8, 2024

6 This novel study marks a significant milestone in the field, evaluating the effectiveness of FFR CT in detecting ischemia-producing coronary stenosis in patients with severe PAD. Diagnosis and treatment of ischemia-producing coronary stenoses improves 5-year survival of patients undergoing major vascular surgery.” Circulation, vol.

Coronary Artery Disease

Coronary Artery Disease Chest Pain Ischemia Myocardial Infarction

Does this T wave pattern mean anything?

Dr. Smith's ECG Blog

OCTOBER 23, 2023

Edited by Bracey, Meyers, Grauer, and Smith A 50-something-year-old female with a history of an unknown personality disorder and alcohol use disorder arrived via EMS following cardiac arrest with return of spontaneous circulation. 2017 Oct 1;177(10):1520-1522. Circulation. JAMA Intern Med. doi: 10.1001/jamainternmed.2017.3191.

Tachycardia

Tachycardia Cardiac Arrest ICU Blog

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Bridging Innovation & Patient Care: The Growing Role of AI

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What are treatment options for this rhythm, when all else fails?

Dr. Smith's ECG Blog

JULY 21, 2024

There is no definite evidence of acute ischemia. (ie, Simply stated — t he patient was having recurrent PMVT without Q Tc prolongation, and without evidence of ongoing transmural ischemia. ( Some residual ischemia in the infarct border might still be present. Both episodes are initiated by an "R-on-T" phenomenon.

Arrhythmia

Arrhythmia Cardiogenic Shock Bradycardia Defibrillator

VF arrest at home, no memory of chest pain. Angiography non-diagnostic. Does this patient need an ICD? You need all the ECGs to know for sure.

Dr. Smith's ECG Blog

JUNE 23, 2024

They shocked him twice before return of spontaneous circulation. This was interpreted by the treating clinicians as not showing any evidence of ischemia. When EMS arrived the patient was in ventricular fibrillation. He was intubated in the field and sedated upon arrival at the hospital.

Chest Pain

Chest Pain Cardiac Arrest Sudden Cardiac Death Blog

Abstract TP163: Single- and Multi-Phase Computed Tomography Angiography Are Associated with Digital Subtraction Angiography and American Society of Interventional and Therapeutic Neuroradiology Collateral Score of Three or Greater

Stroke Journal

JANUARY 30, 2025

Collateral status is a well-documented marker of reperfusion and mortality in patients with large vessel occlusion (LVO) anterior circulation strokes, which account for approximately one-third of AIS. Methods:We retrospectively evaluated AIS patients treated at our institution between January 2017 and January 2023.

Document

Document Circulation Strokes Stroke

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 Ischemia Heart Failure

Lowering Atherosclerotic Cardiovascular Disease Events by Treating Residual Inflammatory Risk

DAIC

JANUARY 23, 2024

Inflammation driven by signaling cytokines, circulating immune cells, adhesion molecules, and oxidized low-density lipoprotein cholesterol (LDL-C) leads to atherosclerotic plaque development, plaque progression, and eventual rupture.14,15 2019 Sep 10;140(11):e649-e650] [published correction appears in Circulation. Circulation.

Cardiovascular Disease

Cardiovascular Disease Heart attacks Heart Attack Coronary Artery Disease

A man in his 70s with weakness and syncope

Dr. Smith's ECG Blog

JULY 22, 2023

For now, the 2017 AHA/ACC/HRS guidelines for asymptomatic patients that have inducible types of Brugada syndrome recommend observation without any specific therapies or interventions [8]. Circulation, 117, 1890–1893. [3]: Heart Rhythm, 13(7): 1515-1520. [2]: 3]: Lamelas P, Labadet C, Spernanzoni F, Lopez Saubidet C, and Alvarez PA.

Chest Pain

Chest Pain Heart Rhythm Sudden Cardiac Death Dysrhythmia

Hyperthermia and ST Elevation

Dr. Smith's ECG Blog

JANUARY 30, 2019

For now, the 2017 AHA/ACC/HRS guidelines for asymptomatic patients that have inducible types of Brugada syndrome recommend observation without any specific therapies or interventions [8]. Circulation, 117, 1890–1893. [3]: Heart Rhythm, 13(7): 1515-1520. [2]: 3]: Lamelas P, Labadet C, Spernanzoni F, Lopez Saubidet C, and Alvarez PA.

Heart Rhythm

Heart Rhythm Sudden Cardiac Death Arrhythmia STEMI

How can Warfarin be safe “even in” first trimester of pregnancy ? The story behind the 5 mg cut-off !

Dr. S. Venkatesan MD

MARCH 19, 2024

Most IVF pregnancies seem to need it for some unknown reason) Risk of VTE Recurrent pregnancy loss(Placental micro-circulation clogging) SLE/APLA syndrome /Scleroderma VTE related PAH Mitral valve disease with AF. 2017 Jun 6;69(22):2692-2695. The list is increasing in a steady fashion. What does it imply ? J Am Coll Cardiol.

Heart Valves

Heart Valves Blood Clot Heart Disease Bicuspid/Mitral

Of Twists and Turns

EMS 12-Lead

APRIL 28, 2022

In most cases, rather, the culprit is gross ischemia due to myocardial infarction, cardiomyopathy, or advanced coronary artery disease. Circulation, 144; 823-839. [3] Circulation, 59 (3); 459-468. [8] Circulation: Arrhythmia and Electrophysiology, 4 ; 2-4. Wolters-Kluwer: Philadelphia, PA. [2] 2] Viskin, S., 8] Liu, E.,

Tachycardia

Tachycardia AFIB Arrhythmia Coronary Artery Bypass Graft

Chest pain and T wave inversion, NSTEMI?

Dr. Smith's ECG Blog

AUGUST 10, 2023

But two features were concerning: An ECG showing reperfusion indicates high risk for reocclusion – either from a transiently open artery at risk of closing, or an artery that is still occluded but with perfusion tenuously maintained by collateral circulation The patient had ongoing ischemic symptoms, suggesting ongoing occlusion. Shroff, G.

Chest Pain

Chest Pain STEMI Ischemia Nursing

Abstract TP225: Larger Basilar Arterial Diameters Correlate with Reduced Blood Flow Velocities in Ischemic Stroke Patients

Stroke Journal

JANUARY 30, 2025

However, the mechanisms underlying brain ischemia in DE are not well understood. The mean age was 64 13 years, 66% were male, 36% had posterior circulation stroke, 11.4% Diameter of the BA was measured using semiautomatic vessel segmentation, and DE was defined as a BA diameter greater than the 95th percentile stratified by sex.

Strokes

Strokes Stroke Stenosis 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. ST segment and T wave abnormalities consistent with or possibly related to myocardial ischemia. Circulation. And these findings come from OESIL , EGSYS , and Sarasin studies: i: Non-sinus rhythm ii: SVT or VT (obviously, and this makes for an abnormal vital sign anyway) iii.

Arrhythmia

Arrhythmia Outcomes Chest Pain Risk Factors

Can you localize the culprit lesion on angiogram without taking ECG findings into account?

Dr. Smith's ECG Blog

MARCH 25, 2025

There is low voltage in the precordium which always makes reading ischemia harder. In ACS, chest pain is the warning sign of ongoing ischemia. Smith : As Willy says, and as we've said many times before, morphine will resolve pain without resolving ischemia. ECG 1 What do you think? To me, this ECG is not diagnostic.

Chest Pain

Chest Pain Ischemia Plaque Stent

Chest pain followed by 6 days of increasing dyspnea -- what happened?

Dr. Smith's ECG Blog

FEBRUARY 26, 2025

Denying patients the potential benefit of revascularization just because their symptoms have lasted a certain amount of time shows poor understanding of the pathophysiology of myocardial ischemia. There were no other causes of dyspnea apparent and thus we can assume that myocardial ischemia started 6 days prior.

Chest Pain

Chest Pain Pericarditis Myocardial Infarction Dementia

Update on Diagnosis and Management of Kawasaki Disease: A Scientific Statement From the American Heart Association

HeartFlow Announces Revolutionary Five-Year Data Demonstrating a 63 Percent Mortality Reduction with FFRCT-Guided Care in PAD Patients

Does this T wave pattern mean anything?

Webinars

What are treatment options for this rhythm, when all else fails?

VF arrest at home, no memory of chest pain. Angiography non-diagnostic. Does this patient need an ICD? You need all the ECGs to know for sure.

Abstract TP163: Single- and Multi-Phase Computed Tomography Angiography Are Associated with Digital Subtraction Angiography and American Society of Interventional and Therapeutic Neuroradiology Collateral Score of Three or Greater

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

Lowering Atherosclerotic Cardiovascular Disease Events by Treating Residual Inflammatory Risk

A man in his 70s with weakness and syncope

Hyperthermia and ST Elevation

How can Warfarin be safe “even in” first trimester of pregnancy ? The story behind the 5 mg cut-off !

Of Twists and Turns

Chest pain and T wave inversion, NSTEMI?

Abstract TP225: Larger Basilar Arterial Diameters Correlate with Reduced Blood Flow Velocities in Ischemic Stroke Patients

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

Can you localize the culprit lesion on angiogram without taking ECG findings into account?

Chest pain followed by 6 days of increasing dyspnea -- what happened?

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