2018 Chest Pain Plaque 
Dr. Smith's ECG Blog
OCTOBER 24, 2019
[link] A 30 year-old woman was brought to the ED with chest pain. She had given birth a week ago, and she had similar chest pain during her labor. She attributed the chest pain to anxiety and stress, saying "I'm just an anxious person." A similar episode had occurred a week earlier during labor.
DAIC
JANUARY 3, 2024
With more than 500 peer-reviewed publications, the HeartFlow FFR CT Analysis remains unparalleled in precision coronary care, as supported by the ACC/AHA Chest Pain Guidelines, to improve treatment plans and outcomes. Neth Heart J 2018. 2021 ACC/AHA Chest Pain Guidelines. Arbab-Zadeh, Heart Int 2012. Patel et al.
Dr. Smith's ECG Blog
JULY 11, 2018
A 40-something woman had sudden chest pain. Today, they viewed the angiogram and concluded that the thrombus at the mid RCA must have extended proximally from the culprit ruptured plaque, extending proximal to the RV marginal branch and temporarily occluding it. She called 911. But which myocardial walls are affected?
Dr. Smith's ECG Blog
JULY 31, 2018
See this post: Classic Evolution of Wellens' T-waves over 26 hours This is one patient, with ECG recorded at time zero after pain resolution, then at time 2 hours, then at time 9 hours. Given that chest pain is resolving at the time ECG #2 was recorded — this supports the concept of dynamic ST-T wave changes in this patient.
Dr. Smith's ECG Blog
NOVEMBER 4, 2022
The best course is to wait until the anatomy is defined by angio, then if proceeding to PCI, add Cangrelor (an IV P2Y12 inhibitor) I sent the ECG and clinical information of a 90-year old with chest pain to Dr. McLaren. His response: “subendocardial ischemia. Miranda DF, Lobo AS, Walsh B, et al.
Dr. Smith's ECG Blog
JANUARY 15, 2024
They had difficulty describing their symptoms, but complained of severe weakness, nausea, vomiting, headache, and chest pain. They described the chest pain as severe, crushing, and non-radiating. Altogether, this strongly suggests inferolateral OMI, particularly in a patient with acute chest pain.
Dr. Paddy Barrett
JANUARY 30, 2024
The CAC scan looks for deposits of calcium in the areas of the coronary arteries as a proxy marker for plaque. It tells you ‘ if ’ there is plaque and how much, as a score called a CAC score. About 1 in 10 patients with a CAC of 0 will have some plaque identified on more in-depth scanning using CTCA 1. Int J Cardiol.
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