Remove 2020 Remove Atherosclerosis Remove Plaque
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Why Waiting Until Age 50 To Address Risk Factors For Heart Disease Is Too Late.

Dr. Paddy Barrett

The reason: They were accumulating plaque in their coronary arteries much earlier than their peers. You can’t have a heart attack if you don’t have plaque in your coronary arteries. And plaque in your coronary arteries is the result of exposure to risk factors over time. The answer: Risk Factors. The answer.

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Suboptimal Control of Small Dense Low‐Density Lipoprotein Cholesterol Is Associated With Coronary Plaque Progression: An Intravascular Ultrasound Study

Journal of the American Heart Association

BackgroundPlaque progression (PP) is critical between subclinical atherosclerosis and plaque rupture. Journal of the American Heart Association, Ahead of Print. Small dense lowdensity lipoprotein cholesterol (sdLDLC) is considered as the most atherogenic lipoprotein.

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What does the angiogram show? The Echo? The CT coronary angiogram? How do you explain this?

Dr. Smith's ECG Blog

MINOCA may be due to: coronary spasm, coronary microvascular dysfunction, plaque disruption, spontaneous coronary thrombosis/emboli , and coronary dissection; myocardial disorders, including myocarditis, takotsubo cardiomyopathy, and other cardiomyopathies. See "Mechanisms of acute coronary syndromes related to atherosclerosis".)

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1 hour of CPR, then ECMO circulation, then successful defibrillation.

Dr. Smith's ECG Blog

If the arrest was caused by acute MI due to plaque rupture, then the diagnosis is MINOCA. Here is my comment on MINOCA: "Non-obstructive coronary disease" does not necessarily imply "no plaque rupture with thrombus." They often cannot even be recognized as culprits, as fissured or ulcerated plaque. FFR can be useful.

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Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting."

Dr. Smith's ECG Blog

To prove there is no plaque rupture, you need to do intravascular ultrasound (IVUS). An angiogram is a "lumenogram;" most plaque is EXTRALUMINAL!! One of the most common is rupture of a non-obstructive plaque, with thrombus formation and OMI that spontaneously lyses and leaves a wide open artery. It can only be seen by IVUS.

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Cardiac Arrest. What does the ECG show? Also see the bizarre Bigeminy.

Dr. Smith's ECG Blog

Angiogram --Minimal coronary atherosclerosis --No obstructive epicardial coronary artery disease or evidence of plaque rupture noted to explain prolonged QT or ventricular fibrillation cardiacarrest, suspect nonischemic mechanism Echo The estimated left ventricular ejection fraction is 45 %. .

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Elucid Commences International PRE-VUE CCT Registry Study

DAIC

This registry will aim to provide world-wide physicians the most accurate information on coronary plaque to improve cardiovascular risk prediction and support the selection of patient-specific treatment,” said Dr. De Cecco. The ultimate goal is to positively impact cardiovascular health globally with a reduction in cardiovascular events."

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