Ken Grauer, MD

JULY 15, 2023

CT coronary angiogram — No obstructive coronary disease. CT coronary angiogram showed no obstructive coronary disease. But immediate resolution of chest pain once VT was converted — and — the normal CT coronary angiogram — essentially ruled out acute coronary disease as the cause.

Blog 78

Blog Coronary Angiogram Cardiomyopathy Ischemia 78

Dr. Smith's ECG Blog

DECEMBER 9, 2023

A Coronary angiogram from 8 years prior revealed that he had had an inferior posterior STEMI at the time due to 100% occlusion of the proximal RCA. Regional wall motion abnormality- inferior and inferolateral. A QR-wave is far more common, just like you would see in inferior ACUTE OMI.

Aneurysm 115

Aneurysm Chest Pain Echocardiogram STEMI 115

Dr. Smith's ECG Blog

MARCH 17, 2023

She had a prior history of "NSTEMI" one month ago, during which she had a coronary angiogram reportedly showing no stenosis in any coronary artery. A very similar case to the one presented today appears in the January 17, 2023 post of Dr. Smith’s ECG Blog. 17, 2023 post ). Her vitals were within normal limits.

Chest Pain 52

Chest Pain Coronary Angiogram Circulation Electrocardiogram 52

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.

Pericarditis 78

Pericarditis Blog Chest Pain Coronary Angiogram 78

Dr. Smith's ECG Blog

SEPTEMBER 16, 2024

A coronary angiogram was done that did not show significant coronary artery disease. I have periodically called attention to examples of the Ashman phenomenon as they occur in Dr. Smith's ECG Blog ( See My Comments in the January 5, 2020 post — the June 17, 2020 post — and the March 30, 2023 post , among others ).

Cardiac Arrest 68

Cardiac Arrest Cardiomyopathy Arrhythmia Atrial Fibrillation 68

Dr. Anish Koka

MAY 16, 2023

Diamond and Forrester accomplished this by first establishing the prevalence of coronary artery disease based on how clinically likely patients with chest pain symptoms were found to have coronary disease based on a coronary angiogram. But these are words you won’t find in the chest pain guidelines of 2023.

Chest Pain 52

Chest Pain Coronary Artery Disease Cancer Heart Attack 52

Dr. Smith's ECG Blog

MAY 16, 2023

Like they would for any other acute arterial occlusion syndrome (such as suspicion of acute large vessel stroke), they take the patient across the hall and perform an immediate CT (coronary) angiogram, showing patent coronaries. An emergent echo also confirms no regional wall motion abnormality.

Chest Pain 52

Chest Pain Pericarditis Tachycardia STEMI 52

Dr. Smith's ECG Blog

JANUARY 9, 2023

Young people can suffer acute coronary occlusion, whether by typical atherosclerotic plaque rupture, or by coronary anomalies, coronary aneurysms, dissections, spasm, etc. My Comment by K EN G RAUER, MD ( 1/9 /2023 ): = “ Treat the patient — Not the age of the patient”. A missed OMI like this can be devastating. =

Chest Pain 52

Chest Pain Aneurysm STEMI Thrombosis 52

Dr. Smith's ECG Blog

MARCH 3, 2025

Case Continued The patient was discharged from the hospital with a plan for a scheduled coronary angiogram to assess the coronary arteries and the possibility of aortic valve replacement. The vast majority of ischemia from supply demand mismatch is diffuse ST depression, with ST Elevation in aVR.

Tachycardia 74

Tachycardia Pulmonary Chest Pain Stenosis 74

Dr. Smith's ECG Blog

FEBRUARY 6, 2025

CT coronary angiogram showed a hypoplastic RCA and dominant LCx. Figure-5: Long lead II recording on oral flecainide ( 10 minutes of continuous recording each line being 1-minute long ). No PVCs are seen. A workup was undertaken in search of a cause of the patient's ventricular arrhythmia. There were no plaques or stenoses.

Tachycardia 72

Tachycardia Arrhythmia Ablation Atrial Flutter 72