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How terrible can it be to fail to recognize OMI? To whom is OMI Obvious or Not Obvious?

Dr. Smith's ECG Blog

Given that this is before it is released into the circulation by reperfusion therapy, this is a massively elevated troponin. She was taken to the cath lab, where she was found to have 100% in-stent restenosis of the proximal LAD. Prompt cath to define the anatomy should be expedited. Smith : Continued (subacute) anterior OMI.

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Abstract 4140682: Clinical Case: Flipping the Script: Tackling CAD in Dextrocardia During Cardiac Catheterization

Circulation

Circulation, Volume 150, Issue Suppl_1 , Page A4140682-A4140682, November 12, 2024. After guidewire crossing, balloon angioplasty was performed, and a drug-eluting stent was deployed. Introduction:Dextrocardia is a rare congenital condition where the heart's apex points to the right, with an incidence of about 0.01%.

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Abstract 173: A Case Series of Basilar Tip Aneurysm Endovascular Treatment – The Barrow Neurological Institute Experience

Stroke: Vascular and Interventional Neurology

IntroductionBasilar‐tip aneurysm (BTA) is the most common aneurysm found in the posterior circulation, representing 5–8% of total intracranial aneurysms. Stents approved by FDA after 2014 (used in 13 cases) had a greater rate of retreatment (46.2% Stroke: Vascular and Interventional Neurology, Volume 3, Issue S2 , November 1, 2023.

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Inferior Subtle ST elevation: straight ST segment, but also no reciprocal ST depression in aVL: which is more important?

Dr. Smith's ECG Blog

60-something with h/o MI and stents presented with chest pain radiating to the back and nausea/vomiting. It was stented. The patient had a p rior h istory of MI + stents. Time zero What do you think? There is inferior ST elevation. Is it normal variant? Is it ischemic (OMI)? Pericarditis?

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A young patient with diminishing pain with a subtle but diagnostic ECG.

Dr. Smith's ECG Blog

Compare to the anatomy after stenting: The lower of the 2 now easily seen branches is the circumflex, now with excellent flow. Circulation 2002; 105(4): 539-42. Here is his angiogram: This shot shows that the left circumflex (LCx) is occluded at the ostium (origin). This is seen just millimeters beyond the tip of the catheter.