Anatomy, Coronary Angiogram and Plaque

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Anatomy

Coronary Angiogram

Plaque

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

NOVEMBER 4, 2022

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. All electrocardiograms (ECGs) and coronary angiograms were blindly analyzed by experienced cardiologists.

Ischemia

Ischemia STEMI Stenosis Coronary Artery Disease

A teenager with chest pain, a troponin below the limit of detection, and "benign early repolarization"

Dr. Smith's ECG Blog

JANUARY 9, 2023

Only after her troponin peaked at 500,000 ng/L did she get her angiogram, which showed a 100% left main occlusion due to ruptured plaque. Young people can suffer acute coronary occlusion, whether by typical atherosclerotic plaque rupture, or by coronary anomalies, coronary aneurysms, dissections, spasm, etc.

Chest Pain

Chest Pain Aneurysm STEMI Thrombosis

Cardiovascular Update

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

A teenager with chest pain, a troponin below the limit of detection, and "benign early repolarization"

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