Dr. Smith's ECG Blog
NOVEMBER 15, 2023
Post cath ECG: Now there are hyperacute T-waves again, and recurrent ST depression in V2 This ECG would normally diagnostic of OMI until proven otherwise No further troponins were measured, but it looks like there is recurrent OMI Next day: A CT Coronary Angiogram was done (CTCA) CARDIAC MORPHOLOGY AND FUNCTION: 1. IMPRESSION: 1.
Dr. Smith's ECG Blog
JANUARY 2, 2025
Finally, do a coronary angiogram Possible alternative to pacing is to give a beta-1 agonist to increase heart rate. Applying my method to the March 19, 2019 case that I show in Figure-1 the rhythm in this Figure-1 ECG is regular, with an R-R interval just under 4 large boxes. Dobutamine is an acceptable alternative.
Ken Grauer, MD
FEBRUARY 24, 2023
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.
Dr. Smith's ECG Blog
JUNE 19, 2024
The patient was taken emergently to the cath lab for a pericardiocentesis instead of a coronary angiogram. The ED provider canceled the STEMI protocol and updated the cath lab on the finding. In the cath lab, 150 CCs of bloody fluid were drained from the pericardium.
Dr. Smith's ECG Blog
MAY 19, 2022
Ct coronary angiogram showed normal coronary arteries. Smith note: I think CT coronary angiogram is reasonable with the elevated troponins and symptoms. International Journal of Cardiology 2019. He was given aspirin and heparin and transferred to the local cardiac center for further evaluation. Paana et al.
Dr. Smith's ECG Blog
NOVEMBER 4, 2022
Diffuse ST depression with ST elevation in aVR: Is this pattern specific for global ischemia due to left main coronary artery disease? Incidence of an acute coronary occlusion. Am J Med 2019, 132(5):622-630. Incidence of an Acute Coronary Occlusion. American Journal of Medicine 132(5):622-630; May 2019.
EMS 12-Lead
MAY 20, 2022
Cardiology felt her chest pain to be, most likely, the result of coronary supply-demand mismatch in the context of HCM endothelial remodeling (i.e. Type II MI), however decided to pursue coronary angiogram out of an abundance of caution. A mid-LAD culprit lesion was identified and stented. References Naidu, S. Tower-Rader, A.
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