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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.
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. (
The transaction follows Johnson & Johnson MedTech’s successful acquisitions of Abiomed , a leader in heart recovery, and more recently Laminar, an innovator in left atrial appendage elimination for patients with non-valvular atrial fibrillation (AFib). In addition to its leading IVL platform, Shockwave also recently acquired Neovasc Inc. ,
The patient is female in her 80s with a medical hx of previous MI with PCI and stent placement. The patient also has a history of AFib and HFmrEF ( = H eart F ailure with M inimally- R educed E jection F raction ). She also has a hx of paroxysmal atrial fibrillation and is on oral anticoagulant treatment.
Meyers, awareness that this patient had just been started on Flecainide for treatment of AFib, but without concomitant use of an AV nodal blocking agent — greatly increases the likelihood that the SVT rhythm in ECG #1 is the result of a proarrhythmic effect of Flecainide ( ie, conversion of AFib to AFlutter with 1:1 AV conduction ).
They had a history of non-ischemic cardiomyopathy (EF 30%), as well as PCI with one stent. Only AFib was induced during EP study. Home medications included metoprolol, but no calcium- or sodium-channel blocking agents. Initial ECG in the ED: Presenting ECG : Wide-complex tachycardia at a rate about 200.
It is asking for stenting all non-flow limiting lesion , if found, to carry high risk plaques by intracoronary Imaging. Top 10 Clinical Trials Preventive PCI on Stenosis With Functionally Insignificant Vulnerable Plaque PREVENT (ACC.24) 24) Microaxial Flow Pump in Infarct-Related Cardiogenic Shock DanGer Shock (ACC.24)
It was opened and stented. The April 6, 2023 post — excessive baseline artifact misdiagnosed as AFib ( instead of sinus rhythm with AV Wenckebach — as in Figure-4 in this post ). The ramus is an occasional artery between the circumflex and the LAD, and often takes the place of a large first diagonal, and has the same distribution.
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