Remove Anatomy Remove Coronary Angiogram Remove Echocardiogram
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90 year old with acute chest and epigastric pain, and diffuse ST depression with reciprocal STE in aVR: activate the cath lab?

Dr. Smith's ECG Blog

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 chest pain to Dr. McLaren. See this case: what do you think the echocardiogram shows in this case?

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How do I get that elusive courage, to diagnose false positive TMT, without CAG ?

Dr. S. Venkatesan MD

Mostly, you can’t escape from a coronary angiogram” Next option is CT angiogram, Thallium or dobutamine stress. Out of 5 cardiologists I consulted, 4 asked me to go for an immediate angiogram. The shrewd cardiologist did a bicycle ergometry and simultaneous echocardiogram without any drugs or injections.

Anatomy 52
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Electrical instability in a healthy 50 year old. How to manage?

Dr. Smith's ECG Blog

CT coronary angiogram showed a hypoplastic RCA and dominant LCx. It is reasonable to perform an echocardiogram to evaluate LV function. Figure-5: Long lead II recording on oral flecainide ( 10 minutes of continuous recording each line being 1-minute long ). No PVCs are seen. There were no plaques or stenoses.