Stroke Journal

FEBRUARY 1, 2024

Stroke, Volume 55, Issue Suppl_1 , Page A48-A48, February 1, 2024. Objective:To compare the 1-month stroke, myocardial infarction (MI), and/or death rates among symptomatic patients undergoing either CAS or CEA according to the timing of the procedure in Carotid Revascularization Endarterectomy versus Stenting Trial (CREST).Methods:We

Stent 40

Stent Stents Stenosis Myocardial Infarction 40

Stroke Journal

JANUARY 30, 2025

To our knowledge, no studies have directly compared the right and left TRA for carotid artery stenting (CAS). The right TRA was performed as a first-line approach from 2019 to 2021, with the left TRA being used thereafter. All carotid stenoses were successfully dilated.

Stent 40

Stent Stents Aortic Interventional Cardiology 40

Dr. Smith's ECG Blog

NOVEMBER 3, 2023

A man in his 70s with past medical history of hypertension, dyslipidemia, CAD s/p left circumflex stent 2 years prior presented to the ED with worsening intermittent exertional chest pain relieved by rest. The baseline ECG is basically normal with no ischemia. In my opinion, I think it looks more like subendocardial ischemia.

Chest Pain 82

Chest Pain Cardiogenic Shock Ischemia Myocardial Infarction 82

Dr. Smith's ECG Blog

AUGUST 6, 2024

In any case, the ECG is diagnostic of severe ischemia and probably OMI. So this could be myocarditis but in my opinion needs an angiogram before making that diagnosis. == Dr. Nossen Comment/Interpretation: Evaluation of ischemia on an ECG can be very challenging. Concordant STE of 1 mm in just one lead or 2a.

Chest Pain 104

Chest Pain Ischemia Pericarditis Tachycardia 104

Dr. Smith's ECG Blog

APRIL 18, 2024

Written by Jesse McLaren A 70 year old with prior MIs and stents to LAD and RCA presented to the emergency department with 2 weeks of increasing exertional chest pain radiating to the left arm, associated with nausea. Int J Cardiol 2024 3. Eur Heart J Digital Health 2024 5. Amsterdam et al. Circulation 2014 2. Alencar et al.

STEMI 121

STEMI Chest Pain Myocardial Infarction Blog 121

Dr. Smith's ECG Blog

JUNE 23, 2024

This was interpreted by the treating clinicians as not showing any evidence of ischemia. Given the presentation, the cardiologist stented the vessel and the patient returned to the ICU for ongoing critical care. He was intubated in the field and sedated upon arrival at the hospital. Two subsequent troponins were down trending.

Chest Pain 118

Chest Pain Cardiac Arrest Sudden Cardiac Death Blog 118

Dr. Smith's ECG Blog

JULY 14, 2024

The cath lab was activated, and then not cancelled, and the angiogram showed 99% TIMI 2 flow proximal LAD culprit lesion, stented in less than 90 minutes of arrival. Cath days later showed complete occlusion of the LAD, stented. Ultimately, cardiac cath was done in Case #2, with stenting of the "culprit" LAD lesion.

AFIB 105

AFIB Stent Stents Chest Pain 105

Dr. Smith's ECG Blog

JANUARY 9, 2024

The patient is female in her 80s with a medical hx of previous MI with PCI and stent placement. Are you confident there is no ischemia? Primary VT , and the VT with tachycardia is causing ischemia with chest discomfort (supply-demand mismatch/type 2 MI)? The last echocardiography 12 months ago showed HFmrEF.

Tachycardia 119

Tachycardia Electrophysiology Atrial Flutter Ischemia 119

Dr. Smith's ECG Blog

MARCH 22, 2024

The fact that R waves 2 through 6 are junctional does make ischemia more difficult to interpret -- but not impossible. Back to the assessment of ischemia: Returning to the ECG, the leads that catch my eye first are -- I, II, V4, V5, V6. Ischemia can be disguised by a wide escape rhythm, which decreases the sensitivity of ECG.

Chest Pain 114

Chest Pain STEMI Bradycardia Ischemia 114

Dr. Smith's ECG Blog

OCTOBER 15, 2024

A prehospital “STEMI” activation was called on a 75 year old male ( Patient 1 ) with a history of hyperlipidemia and LAD and Cx OMI with stent placement. Whether these EKGs show myocarditis, a normal variant, or something else, they are overall not typical of transmural ischemia of the anterior or high lateral walls. It was stented.

Chest Pain 116

Chest Pain STEMI Echocardiogram Stent 116

Dr. Smith's ECG Blog

AUGUST 11, 2024

Below is the first ECG recorded by paramedics after 2 hours of chest pain, interpreted by the machine as “possible inferior ischemia”. Cath lab was activated, and found a 95% proximal LAD occlusion which was stented. What do you think?

Chest Pain 100

Chest Pain STEMI Bradycardia Stent 100

Dr. Smith's ECG Blog

SEPTEMBER 25, 2024

The patient’s angiogram should have been expedited, but the EKG change was not recognized as recurrence of transmural ischemia. RAO Caudal View Post PCI This is the RAO Caudal view after thrombectomy and stent placement. The conventional computer algorithm called “ sinus tachycardia, otherwise normal EKG ”.

Chest Pain 120

Chest Pain Blog Hospital Tachycardia 120

Stroke Journal

FEBRUARY 1, 2024

Stroke, Volume 55, Issue Suppl_1 , Page ATMP90-ATMP90, February 1, 2024. At the end of the procedure, there was no statistically significant difference in successful recanalization rates defined as a Modified Treatment in Cerebral Ischemia (mTICI) score of 2b or greater (100% in non-diffuse vs. 90% diffuse, P>0.99).

Hemorrhage 40

Hemorrhage Outcomes Stent Stents 40

Dr. Smith's ECG Blog

NOVEMBER 17, 2024

The operator performed intravascular ultrasound and visualized acute plaque rupture with thrombus formation and placed a stent. There was reperfusion ischemia superimposed on benign T-wave inversion. He is very lucky that he spontaneously reperfused and was stented before he had the chance to re-occlude.

Chest Pain 109

Chest Pain Ischemia Stent Stents 109

Cardiometabolic Health Congress

JANUARY 2, 2025

August 2024 Approvals Minima Stent System (P240003) (Approval Date: August 28, 2024) The Minima Stent System is an expandable cobalt-chromium metal mesh tube to reopen blood vessels in neonates, infants, and children with Coarctation of the Aorta and Pulmonary Artery Stenosis, specifically designed to expand as younger patients grow.

Coronary Artery Disease 52

Coronary Artery Disease Stent Stents Innovation 52

Dr. Smith's ECG Blog

DECEMBER 10, 2024

1) The ECG with active ischemia or reperfusion or subendocardial ischemia or nonspecific (no ischemia) 2) presence or absence of symptoms. (A 2) Rising troponin -- troponin leaks from infarcted myocardium for a long time after ischemia is gone and will rise for a long time. ECG #3 was obtained several hours after PCI.

Chest Pain 108

Chest Pain Ischemia Echocardiogram Stent 108

Dr. S. Venkatesan MD

JANUARY 14, 2025

2024 Nov 22;16(12):1294-1298. Management The web can create a flow disturbance, potentiating local thrombus formation, which can embolize producing resulting in cerebral ischemia. Current treatment is with anti-thrombotics and/or anticoagulation.Lesser option is to alter the flow disturbance caused by the web (surgery or stent).

Strokes 52

Strokes Stroke Ischemia Embolism 52

Dr. Smith's ECG Blog

OCTOBER 31, 2024

Here is the circumflex after stenting: Wide open The cardiologist called Dr. Lufkin back and said "Great call!!" Learn to read the ECG for sublte OMI, and get the Queen of Hearts. == MY Comment , by K EN G RAUER, MD ( 11/1 /2024 ): == The beauty of today's case is its simple efficiency.

STEMI 116

STEMI Arrhythmia Stent Hospital 116

Dr. Smith's ECG Blog

DECEMBER 3, 2024

The RCA was stented successfully with TIMI III flow noted post-procedure and the patient has done well with a post-PCI TTE demonstrating good LVEF and no wall motion abnormality. A good size infarct that no longer has active ischemia will have continually rising troponins due to the damage that was done hours ago.

Catheterization Laboratory 110

Catheterization Laboratory STEMI Blog Ischemia 110

Dr. Smith's ECG Blog

JANUARY 31, 2025

At cath there was a 100% proximal LAD occlusion, which was opened and stented. In this situation, even after the ischemia is relieved and myocardial blood flow is restored myocardial contractile function remains impaired for a variable period of time (usually days to a few weeks). Transient ischemia may lead to "stunning".

STEMI 113

STEMI Chest Pain Myocardial Infarction Ischemia 113

Dr. Smith's ECG Blog

NOVEMBER 23, 2024

It was opened and stented. Compared to TTE from 7/3/24: the anterior regional wall motion abnormality is new and is consistent with ischemia/infarction in the LAD territory == MY Comment , by K EN G RAUER, MD ( 11/20 /2024 ): == There are several insightful aspects of today's case.

Blog 63

Blog Chest Pain Myocardial Infarction Critical Care 63

Dr. Smith's ECG Blog

JANUARY 5, 2025

Unfortunately, although natively conducted beats are the best ones for evaluating ischemia, we only have a few! Moving on to ischemia , the ECG shows reperfused inferoposterolateral infarct. There is just a hint of coving in leads III and aVF suggesting a component of active ischemia which fits with persistent pain.

Chest Pain 77

Chest Pain Ischemia Angina Echocardiogram 77

Dr. Smith's ECG Blog

OCTOBER 30, 2024

Ischemia often produces a straightening of the ST segment and sometimes upward convexity. At cath later the same day, a proximal 99% RCA culprit lesion was stented. Discussion: When a patient presents with chest pain and ST segment elevation we need to evaluate whether or not the ST elevation is ischemic in nature.

Chest Pain 111

Chest Pain Aortic Myocardial Infarction STEMI 111