Dr. Smith's ECG Blog

OCTOBER 24, 2019

Here’s the angiogram of the RCA : No thrombus or plaque rupture in the RCA (or any coronary artery) was found. This MI wasn’t caused by a ruptured plaque of CAD - it was a coronary artery dissection of the RCA. Angiography Angiography was performed after aspirin and heparin were started.

Chest Pain 52

Chest Pain SCAD STEMI Cardiogenic Shock 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

Can J of Cardiol 2018, 34: 132-145 Here are some other cases: LVH, LBBB, RBBB, and RVH may manifest ST depression without any ischemia! Methods STEMI activations between January 2014 and April 2018 at the University of Arizona Medical Center were identified. Miranda DF, Lobo AS, Walsh B, et al.

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52

EMS 12-Lead

AUGUST 22, 2022

The coronary angiogram revealed no critical stenosis, or acute plaque ulceration. Surawicz and Knilans report that intense catecholamine surge, or severe maladjustment of the autonomic nervous system, can manifest “cerebral T waves” in the absence of an acute intracranial process. Furthermore, pertinent electrolyte values (e.g. Friedman, M.,

Tachycardia 52

Tachycardia Electrophysiology Cardiomyopathy ICU 52

Dr. Smith's ECG Blog

JULY 31, 2018

It was long ago that I realized that Wellens' is a reperfusion pattern and the pattern A is early and evolves into Pattern B. -- Comment by K EN G RAUER, MD ( 7/31/2018 ): -- In my experience, the most instructive ECG cases consist of serial tracings with contemporaneous notation at each moment in time as the case evolves. 2012;5:134–137.

SCAD 52

SCAD Chest Pain Myocardial Infarction Ischemia 52

Dr. Paddy Barrett

DECEMBER 27, 2024

A cardiac CT is a low-dose CT scan of your heart that assesses whether or not you have plaque in your coronary arteries and, if so, how much. In general, the more plaque you have, the higher your risk of a heart attack over the next 10 years. 2018 Sep 4;72(10):1141-1156. J Am Coll Cardiol. 6 A Test in Context: Lipoprotein(a).

Coronary Artery Disease 103

Coronary Artery Disease Blood Pressure Cholesterol Heart Disease 103

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.

Heart Disease 96

Heart Disease Heart Attack Heart attacks Plaque 96

Frontiers in Cardiovascular Medicine

FEBRUARY 8, 2024

Objective Assessing the impact of lumbar disc herniation (LDH) on the plaque burden of coronary atherosclerosis is our objective. Methods In this study, a total of 212 patients (age 46–80 years) with unstable angina (UA) who underwent coronary angiography (CAG) in our hospital from January 2018 to July 2022 due to UA were included.

Plaque 59

Plaque Angina Myocardial Infarction Risk Factors 59

Stroke Journal

DECEMBER 28, 2023

Recent evidence suggests that nonstenotic carotid plaque (nsCP) may be a substantial contributor to the risk for ESUS. Stroke, Ahead of Print. BACKGROUND:Many ischemic strokes are diagnosed as embolic strokes of undetermined source (ESUS).

Risk Factors 75

Risk Factors Plaque Embolism Strokes 75

All About Cardiovascular System and Disorders

MARCH 7, 2024

Detailed analysis of the excised carotid plaques were carried out with pyrolysis-gas chromatography-mass spectrometry, stable isotope analysis, and electron microscopy. Primary endpoint of the study was a composite of myocardial infarction, stroke, or death from any cause in those who had micro and nanoplastics in the carotid plaque.

Plaque 52

Plaque Myocardial Infarction Laboratory Cardiac Function 52

DAIC

MAY 8, 2024

It provides anatomic data, plaque identification and characterization, as well as the calculations of FFR CT , a coronary physiological simulation, computed from simulated pressure, velocity and blood flow information obtained from a 3D computer model generated from static coronary CT images. 301–302, [link]. 3 Secemsky, Eric A.,

Coronary Artery Disease 111

Coronary Artery Disease Chest Pain Ischemia Myocardial Infarction 111

Stroke Journal

JANUARY 21, 2024

BACKGROUND:Sex-specific differences in plaque composition and instability underscore the need to explore circulating markers for better prediction of high-risk plaques. Plaque stability was determined by gold-standard histological classifications. Adipokine, lipid, and immune profiling was conducted.

Plaque 40

Plaque Circulation Atherosclerosis Hemorrhage 40

Dr. Paddy Barrett

DECEMBER 26, 2023

A cardiac CT is a low dose CT scan of your heart that assesses whether or not you have plaque in your coronary arteries and if so, how much. In general, the more plaque you have, the higher your risk of a heart attack over the next 10 years.

Coronary Artery Disease 104

Coronary Artery Disease Plaque Heart Attack Heart attacks 104

Dr. Paddy Barrett

APRIL 5, 2024

5 High intensity interval training induces beneficial effects on coronary atheromatous plaques – a randomized trial, European Journal of Preventive Cardiology , 2022;, zwac309, 6 FOURIER Steering Committee and Investigators. 2018 Mar;68(668):151-152. 2006 Apr 5;295(13):1556-65. N Engl J Med. 2017 May 4;376(18):1713-1722.

Heart Disease 119

Heart Disease Coronary Artery Disease Heart Attack Heart attacks 119

Dr. Paddy Barrett

AUGUST 1, 2023

A CTCA provides much more anatomical detail and can identify advanced plaque often missed by CT Coronary Artery Calcium Score scans alone. There are 3 types of coronary atherosclerosis visible on CTCA: Calcified Plaque - Easily Identified on both CT CAC & CTCA scans. Subscribe now How Often Does A CT CAC Scan Miss Plaque?

Coronary Angiogram 52

Coronary Angiogram Plaque Coronary Artery Disease Chest Pain 52

DAIC

JANUARY 25, 2024

Since 2018, exceptional validation results showing CaRi-Heart technology’s ability to aid the prediction of heart attacks have been published in leading medical journals including the Lancet , JACC , European Heart Journal , and Cardiovascular Research.

Heart Attack 110

Heart Attack Heart attacks Technology Cardiovascular Disease 110

Dr. Smith's ECG Blog

OCTOBER 20, 2024

There are multiple possible clinical situations that could account for diffuse subendocardial ischemia that is not due to ACS and plaque rupture. The history in today's case with sudden loss of consciousness followed by chest pain is very suggestive of ACS and type I ischemia as the cause of the ECG changes.

Cardiogenic Shock 127

Cardiogenic Shock Ischemia Chest Pain Cardiac Arrest 127

DAIC

JANUARY 23, 2024

Atherosclerotic cardiovascular disease (ASCVD), caused by plaque buildup in arterial walls, is one of the leading causes of disability and death worldwide.1,2 7 Research has shown inflammation plays a significant role in the development of atherosclerosis and ASCVD,8-10 and even the formation of plaque.11 Published 2018 Feb 6.

Cardiovascular Disease 111

Cardiovascular Disease Heart Attack Heart attacks Coronary Artery Disease 111

Dr. Paddy Barrett

NOVEMBER 28, 2023

Arteries generally narrow and occlude for one of two reasons: The progressive accumulation of plaque. A plaque ruptures, and a clot forms in the artery, thereby occluding it. There are the ‘garden variety’ heart attacks whereby a plaque ruptures in the coronary artery, called a spontaneous heart attack.

Stents 53

Stents Stent Heart Attack Heart attacks 53

Dr. Smith's ECG Blog

OCTOBER 24, 2018

This was diagnosed by IVUS (intravascular ultrasound) as a ruptured plaque. As there was ruptured plaque, this is NOT Prinzmetal's angina. It is just as dangerous, as there is a ruptured plaque with thrombus (which lysed) in the proximal LAD. Values: STE60V3 = 2.0, QRS V2 = 10, RAV4 = 15.5, There was good flow. It was stented.

STEMI 40

STEMI Angina Myocardial Infarction Plaque 40

Dr. Paddy Barrett

DECEMBER 5, 2023

The cause of angina usually involves inadequate blood flow reaching the heart muscle because of significant narrowing of the artery due to plaque buildup. 2018 Jan 6;391(10115):31-40. There are many ways it can present but this is the most common. But coronary stenting is not the only way to reduce symptoms of angina. N Engl J Med.

Stents 59

Stents Stent Angina Heart Attack 59

Dr. Smith's ECG Blog

JANUARY 15, 2024

As an aside, the LCx OMI is a type 2 event, since it is due to supply-demand mismatch from thrombus, and not due to atherosclerotic plaque rupture or erosion). The January 30, 2018 post — for PTA. Then, part of the thrombus embolized into the LCx causing an inferoposterolateral OMI. (As The August 26, 2019 post — baseline artifact.

Chest Pain 63

Chest Pain Blog Arrhythmia Critical Care 63

Dr. Smith's ECG Blog

NOVEMBER 26, 2018

The axiom of "type 1 (ACS, plaque rupture) STEMIs are not tachycardic unless they are in cardiogenic shock" is not applicable outside of sinus rhythm. Atrial Flutter Mimicking ST Depression Inferolateral ST elevation, vomiting, and elevated troponin My Comment by K EN G RAUER, MD ( 11/26/2018 ): Excellent discussion by Drs.

Ischemia 52

Ischemia Atrial Flutter Arrhythmia Tachycardia 52

Dr. S. Venkatesan MD

JANUARY 8, 2024

While the total body seems to do little in determining cholesterol levels, what is more scientifically shocking is slope of the curve between blood LDL levels and plaque burden is rarely linear. 2018 Apr 23;2018:8598054. doi: 10.1155/2018/8598054. LDL is obviously a target against atherosclerosis. Mind you LDL constitutes.000025%

Cholesterol 52

Cholesterol Atherosclerosis Plaque Physiology 52

Dr. Smith's ECG Blog

MARCH 8, 2025

In my review of the literature, there are many articles which purport to demonstrate an acutely increased risk of plaque rupture from emotional stress, but I could not find any credible case reports that were not at least as likely to be takotsubo. Mechanisms of plaque formation and rupture. Coronary plaque disruption.

Cardiomyopathy 74

Cardiomyopathy Myocardial Infarction Defibrillator Bradycardia 74

Dr. Smith's ECG Blog

FEBRUARY 6, 2025

There were no plaques or stenoses. See the September 14, 2018 post for a nice overview of this subject by Dr. Meyers. A workup was undertaken in search of a cause of the patient's ventricular arrhythmia. As noted above echocardiography was completely normal. CT coronary angiogram showed a hypoplastic RCA and dominant LCx.

Tachycardia 71

Tachycardia Arrhythmia Ablation Atrial Flutter 71