Dr. Smith's ECG Blog

NOVEMBER 15, 2023

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. This is in spite of the known proclivity of tighter stenoses to thrombose.

Coronary Angiogram 109

Coronary Angiogram Plaque Thrombosis STEMI 109

Stroke Journal

FEBRUARY 1, 2024

We sought to explore the relationship between ART and stroke risk using population-level data.Methods:We conducted a retrospective cohort study using data from the National Inpatient Sample (NIS) registry from 2015-2020, including all delivery hospitalizations for patients aged 15-55 years. The study exposure was use of ART.

Technology 72

Technology Hospital Stroke Strokes 72

Ken Grauer, MD

SEPTEMBER 21, 2024

There is a literature on this subject ( Sood et al — Cureus 15(4):e37102, 2023 — Gulati et al — Mayo Clin Proceed 95(1):136-156, 2020 — GGF van der Schoot et al: Neth Heart J 28(6):301-308, 2020 — and — Egred at al — Postgrad Med 81(962): 741-745, 2005 — to name just a few reports ). That said — acute MI does occur in younger patients.

Chest Pain 120

Chest Pain Blog Thrombosis Tachycardia 120

Stroke Journal

FEBRUARY 1, 2024

In severe OHSS, increases in capillary permeability can result in hemoconcentration and hypercoagulability leading to thrombotic events, including stroke and cerebral venous thrombosis. HCUP contains both emergency department and inpatient encounters whereas NIS contains a nationally representative sample of inpatient encounters.

Thrombosis 40

Thrombosis Inpatient Embolism Myocardial Infarction 40

Frontiers in Cardiovascular Medicine

NOVEMBER 21, 2024

ObjectiveThis study aims to summarize the clinical experience of using Hem-o-lok clips for the closure of the left subclavian artery (LSA) stump in patients with acute Stanford type A aortic dissection.MethodsClinical data were collected from 96 patients with acute type A aortic dissection admitted to our hospital from January 2020 to December 2022.

Aortic 52

Aortic Thrombosis Aneurysm Stents 52

Circulation

APRIL 7, 2025

The present study aims to characterize racial disparities in long-term outcomes, perioperative outcomes, and health care use after endovascular aortic aneurysm repair.METHODS:We conducted a retrospective cohort study from 2011 to 2019 with outcome assessment through 2020.

Aneurysm 45

Aneurysm Medicare Aortic Outcomes 45

Frontiers in Cardiovascular Medicine

MAY 29, 2024

This study investigates clinical outcomes, aortic remodeling, and abdominal aortic perfusion patterns after TEVAR with the novel Castor device.MethodsFrom November 2020 to June 2023, 29 patients with TBAD involving the LSA were treated with the Castor single-branched stent graft. Of the 102 abdominal aortic branches, 94.1%

Stents 52

Stents Stent Aortic Outcomes 52

Open Heart

APRIL 15, 2022

The 2020 European Society of Cardiology (ESC) Guidelines recommend the use of prasugrel over ticagrelor in patients with non-ST-elevation ACS (NSTE-ACS) intended to receive invasive management (class IIa recommendation), however there are contradictory views regarding this recommendation.

Myocardial Infarction 52

Myocardial Infarction Thrombosis Stents Stent 52

Dr. Smith's ECG Blog

NOVEMBER 14, 2023

We who know ischemic ECGs know that really when T-wave inversion is specific for coronary thrombosis that it indicates reperfusion of the artery, not active occlusion. For examples of this phenomenon — See My Comment in the February 14, 2018 — July 21, 2020 — and December 22, 2022 posts in Dr. Smith's ECG Blog ).

Chest Pain 116

Chest Pain Blog Thrombosis Hospital 116

Stroke Journal

FEBRUARY 1, 2024

Based on the data of discharge patients from 2015 to 2020 (Model Training Set), logistic regression model with restricted cubic splines were applied to construct the "prognostic scale of AIS acute stage based on treatment stratification, PAIST Scale". Patients treated with arterial thrombectomy were excluded. mmol/L = 1).

Thrombolysis 40

Thrombolysis Thrombosis Stroke Strokes 40

Journal of Cardiovascular Electrophysiology

DECEMBER 17, 2024

Methods Patients from a large US hospital system undergoing combined LAAO and left-atrial CA from 8/2020 to 2/2024 were retrospectively analyzed and compared to a control group undergoing LAAO alone. vs. 30.4%, p =0.07) and device related thrombosis (4.5% vs. 2.1%, p =0.72) and minor (27.8%

Ablation 40

Ablation Arrhythmia Thrombosis Echocardiogram 40

Stroke Journal

FEBRUARY 1, 2024

With the information, the APN would recommend change in management accordingly after communicating with the neurology team from the original transferring acute hospital.Results:There were total of 51 issues identified from Aug 2020 to Aug 2021 from 125 patients were reviewed by the Stroke APNs.

Nursing 40

Nursing Hospital Outpatient Strokes 40

Wellnest

JUNE 1, 2023

The World Health Organisation (WHO) formally proclaimed COVID-19, the illness spread by a zoonotic SARS-CoV-2, as a pandemic in March 2020, after it had started to spread in late 2019. Even though the pandemic is on the wane, new studies and evidence about it continue to emerge.

COVID-19 52

COVID-19 Myocardial Infarction Thrombosis Electrocardiogram 52

Cardiometabolic Health Congress

AUGUST 23, 2024

Updated with the latest research since the 2020 edition, this comprehensive report underscores the potential to prevent or significantly delay dementia by targeting modifiable risk factors. Key Takeaways: Up to 50% of all dementia cases could potentially be prevented or substantially delayed.

Dementia 52

Dementia Cholesterol Risk Factors CME 52

Stroke Journal

JANUARY 30, 2025

We aim to assess how AI-ECG prediction model outputs, specifically the AF probability and delta age, are associated with adverse vascular outcomes in patients with migraine.Adult patients diagnosed with MwA and MwoA from 2000-2020 with at least one digital, standard 12-lead ECG were identified.

Atrial Fibrillation 40

Atrial Fibrillation Outcomes Coronary Artery Disease Myocardial Infarction 40

Cardiology Update

FEBRUARY 14, 2024

In the early years of percutaneous coronary intervention (PCI), studies indicated a heightened risk of major adverse cardiac events (MACE) in patients with reduced left ventricular ejection fraction (LVEF), involving outcomes such as death, Q-wave myocardial infarction (MI), stent thrombosis, and repeat revascularization.

Myocardial Infarction 52

Myocardial Infarction Coronary Artery Disease Thrombosis Research 52

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

MINOCA may be due to: coronary spasm, coronary microvascular dysfunction, plaque disruption, spontaneous coronary thrombosis/emboli , and coronary dissection. link] We know that most type 1 acute MI due to plaque rupture and thrombosis occurs in lesions that are less than 50% (see Libby reference).

Plaque 52

Plaque Chest Pain Thrombosis Stenosis 52

EMS 12-Lead

AUGUST 14, 2022

A second 12 Lead ECG was recorded: This is a testament to the dynamic nature of coronary thrombosis and thrombolysis. The patient verbalized spontaneous improvement just before 324mg ASA administration. Here the ST segments are not so deep, nor are the T waves so wide and bulky, because of improved coronary flow at the level of the occlusion.

STEMI 52

STEMI Sudden Cardiac Death Thrombosis Thrombolysis 52

Ken Grauer, MD

FEBRUARY 28, 2023

Microvascular dysfunction — cardiac vasculitis — intravascular thrombosis. These cases provide insight to assessment for MAT: The January 5, 2020 post in Dr. Smith’s ECG Blog — for an example of MAT. Acute pulmonary embolus. ARDS ( A dult R espiratory D istress S yndrome ). SIRS ( S ystemic I nflammatory R esponse S yndrome ).

Blog 78

Blog COVID-19 AFIB Pulmonary 78

Dr. Smith's ECG Blog

DECEMBER 19, 2023

The commonest causes of MINOCA include: atherosclerotic causes such as plaque rupture or erosion with spontaneous thrombolysis, and non-atherosclerotic causes such as coronary vasospasm (sometimes called variant angina or Prinzmetal's angina), coronary embolism or thrombosis, possibly microvascular dysfunction. This is not the case.

Plaque 127

Plaque Angina Blog Stents 127

Dr. Smith's ECG Blog

JUNE 20, 2020

Nevertheless, I don't think a thrombosis related type I MI was ruled out here simply because the patient refused further evaluation. IF you missed the KEY Findings on the pre-hospital ECG of todays case Please take another look at My Comment at the bottom of the page of that February 6, 2020 post.

STEMI 52

STEMI Hospital Coronary Angiogram Dysrhythmia 52

Dr. Smith's ECG Blog

MAY 19, 2020

Coronary thrombosis or embolism can result in MINOCA, either with or without a hypercoagulable state. Shark Fin morphology has been discussed a number of times on Dr. Smith’s ECG Blog ( For review — See the June 11, 2018 post and the January 24, 2020 post , to name just 2 instances ). 24, 2020 post ( link to that post given above ).

Defibrillator 52

Defibrillator Circulation Plaque Cardiac Arrest 52

DAIC

JANUARY 23, 2024

12,16 In 2017, CANTOS (Canakinumab Anti-inflammatory Thrombosis Outcomes Study) provided proof-of-principle that inflammation inhibition in the absence of lipid lowering can significantly reduce cardiovascular event rates and helped to define the interleukin-1 (IL-1) to IL-6 to CRP pathway as a central target in CV disease.16 Circulation.

Cardiovascular Disease 111

Cardiovascular Disease Heart attacks Heart Attack Coronary Artery Disease 111

Dr. Smith's ECG Blog

JANUARY 9, 2023

There is a literature on this subject ( GGF van der Schoot et al: Neth Heart J 28(6):301-308, 2020 — and — Egred et al — Postgrad Med 81(962): 741-745, 2005 — to name just 2 reports ). Meyers at the end of his discussion that refer to multiple cases published on Dr. Smith’s ECG Blog of young adults with acute MI ). Was this coincidence? —

Chest Pain 52

Chest Pain Aneurysm STEMI Thrombosis 52

Dr. Smith's ECG Blog

NOVEMBER 3, 2023

The reappearance of de Winter's pattern caused by acute stent thrombosis: A case report. Academic Emergency Medicine 27(S1): S220; May 2020. Prominent T wave and J-point depression in the precordial leads associated with ST-segment elevation in lead aVR. Am J Emerg Med. 2014;32:e5–e8. Hayakawa A, Tsukahara K, Miyagawa S, et al.

Chest Pain 82

Chest Pain Cardiogenic Shock Ischemia Myocardial Infarction 82

Dr. Smith's ECG Blog

SEPTEMBER 29, 2018

This is a case written by Dan Lee (One of our fantastic Hennepin Residents, class of 2020 ) edits by Smith A 60 something-year-old man with a history of ESRD, LVH and prior CABG presented after an episode of hypotension during his hemodialysis, run followed by a syncopal episode which caused his run to be terminated early.

Chest Pain 52

Chest Pain Myocardial Infarction Cardiac Arrest Ischemia 52

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

IntroductionCerebral venous thrombosis (CVT) is an uncommon form of stroke with relatively low mortality but higher incidence in younger adults.1–3 IntroductionCerebral venous thrombosis (CVT) is an uncommon form of stroke with relatively low mortality but higher incidence in younger adults.1–3 in univariable regression. vs APC 6.8%).

Thrombosis 40

Thrombosis Inpatient COVID-19 Atrial Fibrillation 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

IntroductionCerebral Venous Thrombosis (CVT) is a rare cerebrovascular condition causing death or functional dependency in 10‐15%. Stroke: Vascular and Interventional Neurology, Volume 3, Issue S2 , November 1, 2023. CVT and other diagnoses, and EVT and other procedures, were identified using standard ICD 10 codes.

Thrombosis 40

Thrombosis Cancer Inpatient Hospital 40

Stroke Journal

FEBRUARY 1, 2024

Introduction:Active cancer is a known risk factor for cerebral venous thrombosis (CVT), but it is unknown whether CVT is also associated with occult cancer. Patients admitted to any Dutch hospital between 1997 and 2020 with a first episode of CVT were identified using ICD-9 and ICD-10 codes.

Cancer 40

Cancer Thrombosis Risk Factors Hospital 40

Stroke Journal

FEBRUARY 1, 2024

Introduction:COVID-19 infection has thus emerged to be a new risk factor for Cerebral Venous Thrombosis (CVT). Methods:Adult patients with CVT diagnosis from 2020-2022 in TriNetX COVID research network were included in the study. CVT with COVID patients were more likely to develop deep vein thrombosis at one month (19.8%

COVID-19 40

COVID-19 Outcomes Thrombosis Embolism 40

Stroke Journal

OCTOBER 27, 2023

The composition of thrombi may reflect the mechanism of thrombosis, aiding the determination of the treatment strategy. There was a positive correlation between thrombin and platelets in the cancer group (r=0.666;P=0.001) but not in the control group (r=−0.167;P=0.627).CONCLUSIONS:Cerebral

Cancer 40

Cancer Stroke Strokes Thrombosis 40

Stroke Journal

FEBRUARY 1, 2024

Background and Purpose:Cancer increases the risk for acute ischemic stroke (AIS) and deep venous thrombosis. Methods:We included AIS patients hospitalized at our comprehensive stroke center between January 2015 and December 2020 with available PFO status as detected on transesophageal echocardiography.

Cancer 40

Cancer Stroke Strokes Thrombosis 40

Frontiers in Cardiovascular Medicine

NOVEMBER 19, 2024

MethodsThis retrospective study was conducted between 2020 and 2024, when 24 urgent interventions were performed on 17 patients at our center. However, managing late complications such as stent thrombosis remains a significant challenge. kg), respectively. Notably, there were no intervention-related complications or deaths.

Thrombosis 59

Thrombosis Stents Stent Congenital Heart Disease 59