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ECG Blog #386 — OMI or Something Else?

Ken Grauer, MD

CT coronary angiogram — No obstructive coronary disease. CT coronary angiogram showed no obstructive coronary disease. Today's case is illustrative because it shows how high troponin may rise despite the absence of acute coronary occlusion! ( No sign of ARVC.

Blog 78
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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

This has been termed a “STEMI equivalent” and included in STEMI guidelines, suggesting this patient should receive dual anti-platelets, heparin and immediate cath lab activation–or thrombolysis in centres where cath lab is not available. aVR ST segment elevation: acute STEMI or not? Incidence of an acute coronary occlusion.

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ECG Blog #365 — A 30yo with Pericarditis.

Ken Grauer, MD

Hospital evaluation for this patient was negative for an acute coronary syndrome ( ie, CT coronary angiogram was normal — troponin was not elevated — and Echo was negative, with no sign of pericardial effusion ). CT Coronary Angiogram showed no sign of underlying coronary disease.

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Hypertrophic Cardiomyopathy

EMS 12-Lead

This worried the crew of potential acute coronary syndrome and STEMI was activated pre-hospital. As it currently stands, an ST/S ratio >15% should raise awareness for new anterior STEMI. Type II MI), however decided to pursue coronary angiogram out of an abundance of caution. Pacing Clin Electrophysiol.

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The Bleeding Heart

EMS 12-Lead

STEMI was activated and the patient went to Cath on arrival. It’s judicious, then, to arrange for coronary angiogram. Coronary occlusion, however, might be present concurrently with subendocardial ischemia on the time-zero ECG, or evolve into such. Does the ECG normalize? link] [1] Mirand, D. 2] Aslanger, E.,