Remove AFIB Remove Ischemia Remove Stents
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Which of these, if either, is OMI? Which of these underwent emergent angiography and PCI? Which should have?

Dr. Smith's ECG Blog

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
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Arrhythmia? Ischemia? Both? Electricity, drugs, lytics, cath lab? You decide.

Dr. Smith's ECG Blog

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.

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A fascinating electrophysiology case. What is this wide complex tachycardia, and how best to manage it?

Dr. Smith's ECG Blog

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.

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Morphine + OMI is a bad combination

Dr. Smith's ECG Blog

The patient, albeit very delayed was referred for angiography where a 99% stenosed pRCA was stented. Thoughts about Today's CASE: On occasion — a patient may present for acute care because of CP ( C hest P ain ) due solely to a tachyarrhythmia ( including new AFib, a reentry SVT or VT ). Figure-1: The initial ECG in today's case. (

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Chest (or abdominal?) pain and ECG artifact.

Dr. Smith's ECG Blog

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. The March 17, 2023 post — for PTA.

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