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A 50-something male with hypertension and 20- to 40-year smoking history presented with 1 week of stuttering chestpain that is worse with exertion, which takes many minutes to resolve after resting and never occurs at rest. At times the pain does go to his left neck. It is a ssociated with mild dyspnea on exertion.
Written by Willy Frick A man in his 50s with history of hypertension, hyperlipidemia, and a 30 pack-year smoking history presented to the ER with 1 hour of acute onset, severe chestpain and diaphoresis. His ECG is shown: What do you think? What do you think? This was the cost of preventing infarction of the anterior wall.)
The best course is to wait until the anatomy is defined by angio, then if proceeding to PCI, add Cangrelor (an IV P2Y12 inhibitor) I sent the ECG and clinical information of a 90-year old with chestpain to Dr. McLaren. His response: “subendocardial ischemia.
Coronary Artery Disease (CAD) CAD, which involves the narrowing or blockage of coronary arteries due to plaque buildup, can reduce blood flow to the heart. This may result in ischemia (lack of oxygen to the heart muscle), causing parts of the heart to weaken and enlarge.
No prior exertional complaints of chestpain, dizziness, lightheadedness, or undue shortness of breath. He denied headache or neck pain associated with exertion. I sent this ECG to Dr. Smith, with the only information that it is a 17 year old with chestpain. 24 yo woman with chestpain: Is this STEMI?
For example, if a coronary artery becomes blocked due to plaque buildup (a condition known as coronary artery disease), the heart muscle may not receive enough oxygen, leading to chestpain (angina) or, in more severe cases, a heart attack. Any interruption in this process can result in serious consequences.
Written by Willy Frick A young woman with a history of paroxysmal nocturnal hemoglobinuria presented with acute substernal chestpain. The report describes heavy plaque in the proximal RCA by IVUS, but no lesions in the previously occluded RPL branch and no stent was deployed. < < 35) and rose overnight to 4951.
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 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. First in slow motion with a freeze frame with annotated vessel anatomy, then at normal speed.
In these patients there is no plaque triggered ACS. Strangely, we are also taught , “No ACS should be considered benign, until you see the coronary anatomy” I wish patients realise, how difficult it is to practice cardiology, for that matter any field of emergency medicine.
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