Aneurysm and Angina - Cardiovascular Update

How High Blood Pressure Affects Your Heart and What You Can Do About It

MIBHS

FEBRUARY 15, 2025

Increased Risk of Aneurysms : Chronic high blood pressure can weaken the walls of your arteries, leading to bulging areas known as aneurysms. If an aneurysm ruptures, it can cause life-threatening internal bleeding. This condition reduces blood flow to the heart, increasing the risk of angina (chest pain) and heart attacks.

Blood Pressure

Blood Pressure Hypertension Chest Pain Aneurysm

Is this acute STEMI? LV Aneurysm? Would you give Thrombolytics?

Dr. Smith's ECG Blog

NOVEMBER 17, 2014

There were many comments that it was too late for thrombolytics or that this signified an LV aneurysm, not acute MI. See my formula for differentiating anterior LV aneurysm (that is to say, persistent ST elevation after old MI) from acute anterior STEMI. See my answer below. This is my response: "This is definitely acute or subacute.

Aneurysm

Aneurysm STEMI Chest Pain Risk Factors

H/o MI and stents with brief angina has this ED ECG. And what is Fractional Flow Reserve?

Dr. Smith's ECG Blog

JANUARY 31, 2020

A middle-aged man complained of 15 minutes of classic angina that resolved upon arrival to the ED. Although diagnostic of MI, it is highly suspicious for " Old inferior MI with persistent ST Elevation" or "inferior aneurysm morphology" because of the well-formed Q-waves and the flat T-waves. Here is his initial ECG: What do you think?

Angina

Angina Stent Stents Aneurysm

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Bridging Innovation & Patient Care: The Growing Role of AI

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Young man with chest pain and an abnormal echocardiogram

Heart BMJ

APRIL 15, 2024

The patient was referred for an exercise nuclear study and did 11 min on the Bruce protocol without angina or ischaemic ECG changes. Aortic dissection Sinus of Valsalva aneurysm Anomalous coronary artery Unroofed. Physical examination, an ECG, basic laboratories and a chest X-ray were unremarkable.

Chest Pain

Chest Pain Echocardiogram Angina Laboratory

Abstract 4142012: Ectasias of Multiple Coronary Arteries and a Coronary Cameral Fistula Between Right Coronary Artery and Coronary Sinus

Circulation

NOVEMBER 11, 2024

Coronary angiography revealed a tortuous and extremely aneurysmal RCA, as well as multivessel coronary artery disease (mvCAD) involving LAD, D1, LCx, OM1. Notably, the LAD had multiple aneurysmal segments and areas of eccentric stenosis upto 90%.Multislice CCF can be congenital or acquired and has many variations.

Coronary Artery Bypass Graft

Coronary Artery Bypass Graft ACE Inhibitor Coronary Angiogram Aneurysm

Abstract 092: Vasospasm as a Consequence of IVIg Usage for GBS.

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Some case reports have identified IVIg as potential therapy for vasospasm, while others have implicated it as a causative agent in primarily coronary artery vasospasm and the development of atypical angina.

Angina

Angina Aneurysm Hypertension Strokes

Transient STEMI, serial ECGs prehospital to hospital, all troponins negative (less than 0.04 ng/ml)

Dr. Smith's ECG Blog

JUNE 18, 2011

The old ECG has a Q-wave with persistent ST elevation in lead III, and some reciprocal ST depression (typical for aneurysm morphology). This is "Persistent ST elevation after previous MI" or "LV aneurysm morphology". LV aneurysm is very different for inferior vs. anterior MI.

STEMI

STEMI Pericarditis Hospital Aneurysm

Watch what happens when "pericarditis" and morphine cloud your judgment

Dr. Smith's ECG Blog

JULY 3, 2018

The full thickness infarction with LV aneurysm morphology places him at a higher risk for short and long term complications (e.g., Free wall rupture, VSD, Dresslers Syndrome, chronic CHF, anatomic LV aneurysm, LV thrombus, stroke, etc). No further echocardiograms were available after cath. Teaching points: 1.

Pericarditis

Pericarditis Chest Pain Stent Stents

Hypertrophic Cardiomyopathy

All About Cardiovascular System and Disorders

APRIL 30, 2024

Angina is another common symptom due the hypertrophy which causes a coronary supply demand mismatch Symptoms of HCM include syncope/near syncope, which could be precipitated by exertion, hypovolemia, rapid standing, Valsalva manoeuvre, diuretics, vasodilators or arrhythmia. Doppler echo showing LVOT gradient in HCM.

Cardiomyopathy

Cardiomyopathy Bicuspid/Mitral Document Arrhythmia

Lowering Atherosclerotic Cardiovascular Disease Events by Treating Residual Inflammatory Risk

DAIC

JANUARY 23, 2024

1,2 ASCVD causes or contributes to conditions that include coronary artery disease (CAD), cerebrovascular disease, and peripheral vascular disease (inclusive of aortic aneurysm).3 The benefit was most significant in reducing the incidence of stroke and angina requiring revascularization.35 4 In the U.S. 12 Importantly, colchicine, 0.5

Cardiovascular Disease

Cardiovascular Disease Heart attacks Heart Attack Coronary Artery Disease

Initial Reperfusion T-waves, Followed by Pseudonormalization. Diagnosis?

Dr. Smith's ECG Blog

MARCH 11, 2016

A middle-aged woman had intermittent angina for 48 hours, then onset of constant, crushing chest pain for 1.5 More likely, the patient had crescendo angina, with REVERSIBLE ischemia for 48 hours that only became potentially irreversible (STEMI) at that point in time. Perhaps she will not develop an LV aneurysm.

Myocardial Infarction

Myocardial Infarction Pericarditis STEMI Angina

Chest pain followed by 6 days of increasing dyspnea -- what happened?

Dr. Smith's ECG Blog

FEBRUARY 26, 2025

When there are QS-waves, one should always think about LV aneurysm, but ST to QRS ratio and T-wave to QRS ratio are far too large and not compatible with left ventricular aneurysm. There is some R wave in the lateral precordial leads. Leads V3 and V4 both have 6mm ST elevation. This ECG shows a lot of "acuity".

Chest Pain

Chest Pain Pericarditis Myocardial Infarction Dementia

How High Blood Pressure Affects Your Heart and What You Can Do About It

Is this acute STEMI? LV Aneurysm? Would you give Thrombolytics?

H/o MI and stents with brief angina has this ED ECG. And what is Fractional Flow Reserve?

Webinars

Young man with chest pain and an abnormal echocardiogram

Abstract 4142012: Ectasias of Multiple Coronary Arteries and a Coronary Cameral Fistula Between Right Coronary Artery and Coronary Sinus

Abstract 092: Vasospasm as a Consequence of IVIg Usage for GBS.

Transient STEMI, serial ECGs prehospital to hospital, all troponins negative (less than 0.04 ng/ml)

Watch what happens when "pericarditis" and morphine cloud your judgment

Hypertrophic Cardiomyopathy

Lowering Atherosclerotic Cardiovascular Disease Events by Treating Residual Inflammatory Risk

Initial Reperfusion T-waves, Followed by Pseudonormalization. Diagnosis?

Chest pain followed by 6 days of increasing dyspnea -- what happened?

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