Dr. Smith's ECG Blog

MAY 30, 2023

We recorded an ECG in which V1-V3 were put in the position of V4R-V6R, and V4-6 were placed in V7-9 to (academically) confirm posterior OMI. I say academically because the STD in V2 is diagnostic -- posterior leads are NOT necessary. Angiogram: Culprit Lesion (s): Thrombotic occlusion of the proximal RCA -- stented. What to do?

Chest Pain 97

Chest Pain Myocardial Infarction STEMI Cardiogenic Shock 97

Dr. Smith's ECG Blog

JUNE 12, 2017

He was found to have a 100% circumflex lesion for which a bare metal stent was placed. Academic Emergency Medicine 24(1):120-124. It is not subtle any more. Interventional cardiology was consulted and patient was taken to the cath lab. Imagine if this patient had been at a busy triage and they trusted the computer interpretation.

Chest Pain 52

Chest Pain STEMI Myocardial Infarction Electrocardiogram 52

EMS 12-Lead

MARCH 19, 2023

He denied any known medical history, specifically: coronary artery disease, hypertension, dyslipidemia, diabetes, heart failure, myocardial infarction, or any prior PCI/stent. No appreciable skin pallor. He reported to be a social drinker, but used tobacco products daily. Here is the time-zero 12 Lead ECG.

Myocardial Infarction 52

Myocardial Infarction STEMI Coronary Angiogram Coronary Artery Disease 52

EMS 12-Lead

APRIL 14, 2022

For a detailed review of deWinter OMI visit this post-- [link] Dr. Stephen Smith provides an academic hypothesis concerning the true underlying physiology of deWinter occlusion here-- [link] The clinical significance of HATW's can be found here-- [link] Crews administered 324 mg of ASA and a total of 0.12

ACE Inhibitor 52

ACE Inhibitor Physiology Chest Pain Academic 52

Dr. Smith's ECG Blog

JANUARY 6, 2023

Academic Emergency Medicine 27(S1): S220. A single DES stent was placed, and the patient did well post-procedure. Association between opioid analgesia and delays to cardiac catheterization of patients with occlusion Myocardial Infarctions. Abstract 556. Most other arteries had scattered 20-30% stenoses.

Chest Pain 52

Chest Pain Ischemia Myocardial Infarction ICU 52

DAIC

APRIL 2, 2025

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.

Stents 40

Stents Stent Outcomes Coronary Angiogram 40

Dr. S. Venkatesan MD

APRIL 8, 2025

The goal was to determine whether using FFR to identify functionally significant stenoses (FFR 0.80) for stenting, rather than relying solely on angiographic appearance. FAME series , though never had an intention to compare PCI vs CABG , now we have used the platform to upend it to take on the CABG in multivessel CAD.

Academic 40

Academic Coronary Artery Bypass Graft Coronary Artery Disease Stent 40

Journal of the American Heart Association

JANUARY 12, 2024

Drug‐eluting stents have been shown to be superior to bare‐metal stents in patients with HBR, even when patients were given abbreviated periods of dual antiplatelet therapy (DAPT). Short DAPT has not been evaluated with the EluNIR ridaforolimus‐eluting stent. presented with acute coronary syndrome; 33.7%

Stents 40

Stents Stent Academic Thrombosis 40

Circulation

NOVEMBER 23, 2023

3.30]) and subacute definite or probable stent thrombosis (0.58% and 0.17%; hazard ratio, 3.40 [95% CI, 1.26–9.23]) mg/day) monotherapy or to DAPT with aspirin (81–100 mg/day) and prasugrel (3.75 mg/day) after loading of 20 mg of prasugrel in both groups. years; men, 76.6%; acute coronary syndrome, 75.0%).

Stents 40

Stents Stent Thrombosis Myocardial Infarction 40

Dr. Anish Koka

JULY 23, 2023

Based on these results, Dormu performed a percutaneous transluminal balloon angioplasty and a mechanical atherectomy and stenting of the right superficial femoral artery and stenting of the right superficial femoral artery. Another superficial femoral artery stent was placed as well. All stents were occluded. 4.2.2017.

Vascular Care 52

Vascular Care Outpatient Peripheral Arterial Disease Stent 52

Dr. Smith's ECG Blog

SEPTEMBER 19, 2023

Past medical history includes coronary stenting 17 years prior. If you take old people with a history of MI (he had a stent), that percentage goes far higher since there is scar tissue that acts as a nidus for the PVCs that initiate VT. Definitive diagnosis that ECG #1 is in fact VT is more than academic.

Tachycardia 138

Tachycardia Cardiogenic Shock Angina Blog 138

DAIC

DECEMBER 14, 2023

Doctors then treat the cause of the heart attack, either inserting a stent, removing a clot or taking other necessary action. The NCSI study involved cardiologists at both community hospitals, where many patients with heart attack first present, and large academic centers.

Cardiogenic Shock 105

Cardiogenic Shock Heart Attack Heart attacks Myocardial Infarction 105

Circulation

FEBRUARY 26, 2024

The primary efficacy objective was to demonstrate superiority of PPA to reduce the primary efficacy end point of all-cause death, nonfatal myocardial infarction, nonfatal stroke, stent thrombosis (definite), or urgent revascularization (any vessel) within 30 days.

Myocardial Infarction 40

Myocardial Infarction Academic Thrombosis STEMI 40

Journal of Cardiovascular Pharmacology

MAY 2, 2024

The primary outcome was major adverse cardiac and cerebrovascular event (MACCE), namely a composite of death from cardiovascular causes, myocardial infarction (MI), stroke, stent thrombosis within 12 month. The secondary outcome was Bleeding Academic Research Consortium (BARC) scale bleeding events within 12 months.

Outcomes 40

Outcomes Myocardial Infarction Thrombosis Academic 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

In the present study, we investigated clinical and procedural characteristics predictive of MT success and failure.MethodsWe conducted a retrospective analysis of MT patients with LVO presenting to our academic comprehensive stroke center from 2015‐2020. Recanalization failure was defined as TICI 0‐2a and success as TICI 2b‐3.

Atherosclerosis 40

Atherosclerosis Stent Stents Academic 40

Dr. Smith's ECG Blog

DECEMBER 11, 2023

Here is the angiogram after stent placement. Academic Emergency Medicine 27(S1): S220; May 2020. There is so-called contrast "hangup" in the thrombus which remains from a prior injection, such that it is visible even before injection on this particular clip. The thrombus is circled in red below. The patient suffered a large infarct.

Myocardial Infarction 123

Myocardial Infarction Chest Pain STEMI Blood Pressure 123

Dr. Smith's ECG Blog

NOVEMBER 26, 2018

I limit my comments to a number of academic and semantic concepts relating to the arrhythmia in this case: What is an “SVT”? Serial troponin T measurements rose from zero to 2.80 ng/mL over the next 10 hours. Here is the ECG after intervention: Persistent STE in III and aVF, with persistent STD in V2-V5.

Ischemia 52

Ischemia Atrial Flutter Arrhythmia Tachycardia 52

Cardiology Update

APRIL 9, 2024

The primary superiority endpoint was clinically relevant bleeding (Bleeding Academic Research Consortium [known as BARC] types 2, 3, or 5). The primary non-inferiority endpoint was MACCE (a composite of cardiac death, MI, ischaemic stroke, stent thrombosis, or target vessel revascularisation).

Angina 52

Angina Myocardial Infarction Aortic valve Coronary Artery Disease 52

Dr. Anish Koka

MAY 16, 2023

In their haste to hyperventilate about MINOCA, the authors don’t highlight the high percentage of cardiac interventions that are needed in patients with conventional, common epicardial disease - 80% need a coronary stent and 10% need open heart surgery. 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

NOVEMBER 14, 2024

History of diabetes type II and stent placement in 2018. Here it is: Obvious inferior OMI, and now the STE in V1 is huge, with huge hyperacute T-waves of Right ventricular OMI The cath lab was re-activated: Angiogram: 100% occlusion mid-RCA occlusion (in-stent thrombosis). What do you think? I responded: "Definite inferior OMI.

Academic 126

Academic Stent Stents Thrombosis 126

Dr. S. Venkatesan MD

FEBRUARY 3, 2025

It is a strange academic habit among cardiologists, that they have subdivided medical management into optimal and suboptimal. otherwise, if you keep getting even the slightest doubt and anxiety over the hidden blocks, go for a stent immediately at a good Institution. (My Academic lessons from this patient.

Stent 52

Stent Stents Academic Ischemia 52

Dr. S. Venkatesan MD

MARCH 14, 2025

It is used widely in pre- or post-PCI or even asssit during the implantation of stents. Of course, there were some overuse of OCT as well, as many centers did it for some academic fun, even in some innocuous lesions. Optical coherence tomography (OCT) in secondary revascularisation: stent and graft assessment. Reference 1.

Stent 52

Stent Stents Academic Plaque 52

Dr. S. Venkatesan MD

JANUARY 1, 2025

Welcome to 2025 and best wishes for a great academic journey to all readers. Collected from ACC website (Arranged in three heading) These are the creamy academic extract of whatever happened over the last one year. It is asking for stenting all non-flow limiting lesion , if found, to carry high risk plaques by intracoronary Imaging.

Cardiogenic Shock 59

Cardiogenic Shock Plaque Academic Bicuspid/Mitral 59

Dr. Smith's ECG Blog

MARCH 14, 2025

He eventually underwent CAG, where a circumflex occlusion was stented. Academic Emergency Medicine 27(S1): S220; May 2020. ECG #3 is easily recognized as OMI and the AI model recommends immediate revascularization The patient in today's case received suboptimal care and suffered a substantial myocardial infarction. Abstract 556.

Chest Pain 105

Chest Pain STEMI Myocardial Infarction Ischemia 105