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Chest pain, resolved. Does it need emergent cath lab activation (some controversy here)? And much much more.

Dr. Smith's ECG Blog

First hs troponin I returned 108 minutes after ED arrival and was normal : (12 ng/L) _ No "upstream" P2Y12 were given in the ED ("upstream" means "before the angiogram "defines" the coronary anatomy). Here are other very interesting posts: Wellens' syndrome: to stent or not?

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Abstract 191: Simulating Intracranial Stenosis: A Methodological Approach In An In?Vitro Neurovascular Model

Stroke: Vascular and Interventional Neurology

We aimed to develop a 3D printed ICAD model including realistic features to provide an optimal simulation phantom for research and training purposes.MethodsStereolithography 3D printing technique was used to create a resin neurovascular model based on vascular anatomies extracted from anonymized CTA images.

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Right Heart Catheterization in Tetralogy of Fallot

All About Cardiovascular System and Disorders

Diagnostic cardiac catheterization may be needed especially in tetralogy of Fallot with pulmonary atresia, to assess the pulmonary anatomy, including size and distribution of peripheral pulmonary arteries. Stenting of the patent ductus arteriosus can be considered in neonatal period for improving oxygen saturation till corrective surgery.

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

Circulation

The left circumflex had 80% proximal stenosis with minimal luminal irregularities in the mid to distal portion. After guidewire crossing, balloon angioplasty was performed, and a drug-eluting stent was deployed. An intravascular ultrasound was also performed, which was negative for vessel dissection.

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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. The cath lab was activated: Result: Thrombotic 95% stenosis at the ostium of a small LPL2 with 70% stenosis at the LPL2/LPDA bifurcation in the distal/AV groove Cx Tubular 70% stenosis in the mid-circumflex. (In

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See what happens when hyperacute T-waves are missed

Dr. Smith's ECG Blog

They found an acute lesion of the LAD at the site of the prior stents, including 70% proximal LAD lesion and 95% mid-LAD stenosis with TIMI 3 flow at the time of cath. The LAD lesion was acute and required 3 stents to restore flow. because if it does, then urgent cath to define the anatomy is clearly indicated.

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3 days of shoulder and chest pain, and now cardiogenic shock

Dr. Smith's ECG Blog

Here I annotate it: This shows 100% occluded circumflex (red arrow) and a 90% stenosis of the LAD (Yellow arrow). The LAD was thought to be not thrombotic, but a chronic tight stenosis. Initial priorities in this patient were clearly to determine the anatomy — and reestablish coronary perfusion. Sotalol prolongs the QT 7.