Stroke Journal

NOVEMBER 9, 2023

A combined effort from academic investigators, industry, and regulators is needed to improve imaging technologies and, ultimately, patient outcomes. Imaging in acute ischemic stroke treatment has advanced significantly, but important challenges remain that need to be addressed.

Stroke 40

Stroke Strokes Academic Thrombolysis 40

Dr. Smith's ECG Blog

NOVEMBER 26, 2018

In some cases the ischemia can be seen "through" the flutter waves, whereas in other cases the arrhythmia must be terminated before the ischemia can be clearly distinguished. First , there can simply be diffuse ST depressions (which obligates reciprocal STE in aVR) associated with tachycardia which are not indicative of ischemia.

Ischemia 52

Ischemia Atrial Flutter Arrhythmia Tachycardia 52

Dr. Smith's ECG Blog

AUGUST 2, 2024

In this patient's case, the RV ischemia manifested as dramatic anterior hyperacute T waves. This degree of STE is a bit atypical for LAD ischemia. the investigators reviewed outcomes in 118 patients presenting with NSTEMI. Remember that the RV is the most anterior chamber. Here is a transverse image of a CT showing this.

STEMI 113

STEMI Ischemia Blog Chest Pain 113

Dr. Smith's ECG Blog

NOVEMBER 3, 2023

The baseline ECG is basically normal with no ischemia. You can see in the lead-specific analysis that she "sees" the STD in V5, V5, and II, with STE in aVR as signs of "Not OMI", because subendocardial ischemia pattern is not the same as OMI. In my opinion, I think it looks more like subendocardial ischemia.

Chest Pain 87

Chest Pain Cardiogenic Shock Ischemia Myocardial Infarction 87

Dr. Smith's ECG Blog

JUNE 13, 2024

V1 sits over both the RV and the septum, so transmural ischemia of either one with give OMI pattern in V1 and reciprocal STD in V5 and V6. After being transferred to an academic center, she was taken to the cath lab: Proximal RCA occlusion (causing inferior and RV OMI) Unfortunately, she continued to decline despite aggressive measures.

Chest Pain 92

Chest Pain Document STEMI Defibrillator 92

Dr. Smith's ECG Blog

SEPTEMBER 10, 2023

Smith : the profound persistent STE suggests either persistent occlusion or " no reflow " with persistent downstream ischemia. Long term outcome unknown but obviously bleak. It makes you think you have done something for the ischemia when you have not! Academic Emergency Medicine 27(S1): S220; May 2020. Am Heart J.

STEMI 82

STEMI Myocardial Infarction Ischemia Academic 82

Dr. Smith's ECG Blog

OCTOBER 18, 2023

Most such rhythms in the setting of ischemia are VF and will not convert without defibrillation. This distinction is more than academic — because both treatment and the response to therapy tend to be different with these 2 entities. Acute ischemia? Case continued The tachyarrhythmia terminated on its own. g IV dose of Magnesium.

Cardiac Arrest 108

Cardiac Arrest Tachycardia Cardiomyopathy Bradycardia 108