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 52

Ischemia STEMI Stenosis Chest Pain 52

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 52

Chest Pain Aneurysm STEMI Thrombosis 52

Dr. S. Venkatesan MD

JANUARY 22, 2025

In these patients there is no plaque triggered ACS. we can witness menacingly deep resting ST depression with absolutely no thrombotic process going on in the coronary. Mind you, even a coronary angiogram will not bail you out in terms of decision-making and risk prediction.

Coronary Angiogram 52

Coronary Angiogram Chest Pain Anatomy Angina 52

Dr. Smith's ECG Blog

FEBRUARY 6, 2025

CT coronary angiogram showed a hypoplastic RCA and dominant LCx. There were no plaques or stenoses. A workup was undertaken in search of a cause of the patient's ventricular arrhythmia. As noted above echocardiography was completely normal. Once the arrhythmia was under control cardiac MRi was performed.

Tachycardia 72

Tachycardia Arrhythmia Ablation Atrial Flutter 72