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Coronary artery spasm (CAS), or Prinzmetal angina, is a recognised cause of myocardial ischaemia in non-obstructed coronary arteries which typically presents with anginal chestpain. The patient presented with recurrent palpitations and pre-syncope, with no chestpain.
First runner-up for the YIA is Seokhun Yang, MD , of Seoul National University Hospital, for his abstract, “Prognostic Implications Of Coronary CT Angiography-derived Plaque And Hemodynamic Features On Acute Coronary Syndrome Across Varying Time Intervals: Emerald-ii Study.” and the Ma Family, who provided a $5,000 case prize for the winner.
Stone, MD Mount Sinai Health System tim.hodson Wed, 04/02/2025 - 15:26 March 31, 2025 Using intravascular imaging (IVI) to guide stent implantation during complex stenting procedures is safer and more effective for patients with severely calcified coronary artery disease than conventional angiography, the more commonly used technique.
Influenza-like illness can also trigger plaque rupture. He was given two separate sprays of nitroglycerin sublingually, neither of which improved his pain but did cause him to become briefly hypotensive ( 600 ng/L. The patient has acute persistent refrectory chestpain and elevated troponin. Just go to the cath lab!
A 50 something male presented in the evening to ED for evaluation of chestpain that started at 1600. Note: the 2022 ACC Expert consensus Chestpain guidelines state that "posterior STEMI-Equivalent" is a sign of acute coronary occlusion. The chestpain continued for hours. hours, another ECG was recorded.
Written by Willy Frick A woman in her 60s with very severe hyperlipidemia (LDL >200 mg/dL) presented with acute onset chestpain. She described the pain as moderate in severity, and said it had come and gone several times over the next few hours before ultimately resolving. Her symptoms began while getting off the bus.
Written by Willy Frick A man in his 60s with a history of hypertension and 40 pack-year history presented to the ER with 1 day of intermittent, burning substernal chestpain radiating into both arms as well as his back and jaw. It has been stuttering, lasting 10 minutes at a time with associated diaphoresis.
He denied chestpain. This was attributed to a "Type 2 MI", which is acute MI that is not due to ruptured plaque, but rather due to "supply demand oxygen mismatch". Most MINOCA is due to ruptured plaque with thrombus that lyses and does not leave behind a visible culprit. See these posts: Dynamic OMI ECG.
He had no chestpain, dyspnea, or any other anginal equivalent, and his vital signs were normal. Mechanisms of plaque formation and rupture. Coronary plaque disruption. Just a few weeks ago, I took care of a patient who had ostial RCA OMI (TIMI 0 at cath) and his only complaint was syncope! link] Bentzon, J.
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