2023 Coronary Angiogram Ischemia 
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
JUNE 5, 2024
The ECG does not show any definite signs of ischemia. Nossen — this patient qualified as MINOCA ( M yocardial I nfarction with N on- O bstructive C oronary A rteries ) — since troponin was positive on his 2nd admission, yet there was no evidence of obstructive coronary disease on cath. He denied any exertional chest pain.
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. For more on Torsades de Pointes vs PMVT See My Comment in the October 18, 2023 post and the September 2, 2024 post in Dr. Smith's ECG Blog ). Discontinue all QT proloning medications, including azithromycin 6.
Ken Grauer, MD
JULY 15, 2023
CT coronary angiogram — No obstructive coronary disease. CT coronary angiogram showed no obstructive coronary disease. Today's case is illustrative because it shows how high troponin may rise despite the absence of acute coronary occlusion! ( No sign of ARVC.
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.
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. =
Dr. Smith's ECG Blog
MARCH 3, 2025
The patient was started on heparin for possible NSTEMI vs demand ischemia. increasing stenosis, ischemia, volume changes, increased blood pressure, atrial fibrillation, etc.) The EKGs from the ED presentation were felt by cardiology to represent "subendocardial ischemia." Smith : these ECGs do NOT show subendocardial ischemia.
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