Dr. Smith's ECG Blog

OCTOBER 26, 2010

One very useful adjunct is ultrasound: Echo of his heart can distinguish aneurysm from acute MI by presence of diastolic dyskinesis, but it cannot distinguish demand ischemia from ACS. Furthermore, notice the well-formed Q-waves in inferior leads. These must raise suspicion of old MI with persistent ST elevation.

STEMI 52

STEMI Cardiogenic Shock Tachycardia Aneurysm 52

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. Transient ST elevation is very hazardous.

STEMI 52

STEMI Pericarditis Hospital Aneurysm 52

Dr. Smith's ECG Blog

OCTOBER 15, 2024

The EKG is diagnostic of acute inferior, posterior, and lateral OMI superimposed on “LV aneurysm” morphology. Additionally, a bedside echocardiogram showed no wall motion abnormality and normal LV function. A formal echocardiogram for patient 2 showed normal LV size, wall thickness, and global systolic function.

Chest Pain 116

Chest Pain STEMI Echocardiogram Stent 116

Dr. Smith's ECG Blog

JULY 11, 2024

An echocardiogram showed severely reduced global systolic function with an EF of 20-25% and an LV apical thrombus. The LV aneurysm morphology persists. An echocardiogram showed an EF of 20-25%. Troponin I values trended from 0.262 to 0.746 ng/mL in 6 hours (URL for this assay is 0.034 ng/mL). This is the RAO caudal projection.

Outcomes 113

Outcomes Stenosis Outpatient Echocardiogram 113

Dr. Smith's ECG Blog

JULY 26, 2023

But the well-formed Q-wave and the presence of a normal T-wave in inferior leads led me to believe this was Old Inferior MI with persistent ST Elevation, otherwise known as inferior LV aneurysm. Anterior LV aneurysm is much easier to recognize because the Q-wave is usually a QS-wave (no R-wave at all), in at least one lead.

Aneurysm 52

Aneurysm Chest Pain STEMI Bradycardia 52

Cardiometabolic Health Congress

SEPTEMBER 13, 2024

Kawasaki Disease Case : Angela Khidhir, DO, MSc (USA) presented a compelling case on ACS and tamponade potentially linked to Kawasaki disease-related Coronary Artery Aneurysm. This debate underscored the growing role of CSP despite the current limited evidence supporting it. Memorial Lecture for Dr. Alain Cribier: Prof.

Hypertension 59

Hypertension Cardiovascular Disease Bicuspid/Mitral Arrhythmia 59

Dr. Smith's ECG Blog

JULY 3, 2018

No further echocardiograms were available after cath. 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). Teaching points: 1.

Pericarditis 52

Pericarditis Chest Pain Stent Stents 52

Dr. Smith's ECG Blog

JULY 18, 2014

An echocardiogram showed no hemopericardium, but D oppler showed a new small ventricular septal defect with left to right shunting. Additionally , these patients have a high incidence of LV aneurysm with mural thrombus. No resolution of ST elevation. The T-waves are persistently positive. Bedside echo may detect these in a timely way.

STEMI 52

STEMI Pericarditis Myocardial Infarction Cardiogenic Shock 52

Dr. Smith's ECG Blog

JANUARY 28, 2023

QS waves from V2-V5 consistent with LV aneurysm morphology. Echocardiogram: EF 50%, akinesis of mid-apical anteroseptal, inferior, and inferoseptal myocardium. There is a QS-waves in V2: is this "Old MI with persistent STE (otherwise known as LV aneurysm morphology)"? Normal RV, no valve stenosis or regurgitation. 6.5 = 0.38.

STEMI 52

STEMI Chest Pain Stent Stents 52

Dr. Smith's ECG Blog

DECEMBER 29, 2015

No prior echocardiogram was available for comparison. Is LVH like left ventricular aneurysm? However, an analogous rule for identifying superimposed ACO of the LAD in the presence of persistent STE after prior MI (aka “ left ventricular aneurysm ,” or LVA) was just validated. ECG #3 at 0018 hours. Am J Emerg Med. 2007;25(7):859.e1-e859.e7.

STEMI 40

STEMI Myocardial Infarction Chest Pain Aneurysm 40

All About Cardiovascular System and Disorders

APRIL 30, 2024

Echocardiogram showing thickened interventricular septum and mitral regurgitation in HCM. Mid cavity obstruction in HCM is associated with apical aneurysm, systemic embolism, and arrhythmias. SAM in HCM Systolic anterior movement of mitral valve occurs in 30 – 60%, but it is not specific. Doppler echo showing LVOT gradient in HCM.

Cardiomyopathy 40

Cardiomyopathy Bicuspid/Mitral Document Arrhythmia 40

All About Cardiovascular System and Disorders

APRIL 9, 2024

Echocardiogram in parasternal long axis view shows dilated left ventricle, left atrium, aorta and a small portion of the right ventricle, which is usually the outflow region. Eccentric aortic regurgitation has been reported in ascending aortic aneurysm. PISA method has been described in another video on this channel.

Aortic 40

Aortic Bicuspid/Mitral Aortic valve Stenosis 40

Dr. Smith's ECG Blog

DECEMBER 18, 2022

Next day echocardiogram showed inferolateral hypokinesia with an EF of %45-50. On echocardiogram you will not see a "posterior" hypokinesia (will see "inferolateral") and, as in this case, LCx may not give the blood supply of basal inferior segment (formerly called "posterior"). The patient recovered well.

Myocardial Infarction 40

Myocardial Infarction Chest Pain Blog Echocardiogram 40

Dr. Smith's ECG Blog

APRIL 3, 2019

You might think it is "Old MI with persistent ST Elevation" (otherwise known as "LV aneurysm" morphology.") That is a reasonable thought, but we have shown that if there is one lead of V1-V4 with a T/QRS ratio greater than 0.36, then it is STEMI, not LV aneurysm. Formula value = 20.89, which is much higher than the cutpoint of 18.2

STEMI 40

STEMI Chest Pain Ischemia Aneurysm 40

Dr. Smith's ECG Blog

APRIL 8, 2015

Look for Vascular Etiology -- think of these while doing H and P: --Bleeding: ruptured AAA, GI bleed, ruptured ectopic pregnancy, other spontaneous bleed such as mesenteric aneurysms. Results : Electrocardiograms (99%), telemetry (95%), cardiac enzymes (95%), and head computed tomography (CT) (63%) were the most frequently obtained tests.

Arrhythmia 52

Arrhythmia Outcomes Risk Factors Chest Pain 52

Frontiers in Cardiovascular Medicine

NOVEMBER 7, 2024

There is limited literature regarding cases of giant coronary artery aneurysms (GCAAs), and instances of giant coronary artery pseudoaneurysms caused by trauma are exceedingly rare. Here is a case presentation of an adult male who developed a giant coronary artery pseudoaneurysm following trauma.

Aneurysm 52

Aneurysm Echocardiogram Aortic 52

Conquering CHD

MARCH 24, 2025

An echocardiogram revealed the heart condition that would define much of his early life: severe congenital heart defects. After countless tests, doctors confirmed that it wasnt a seizure, but an aneurysm in his LVOT (left ventricular outflow tract). That test revealed an irregular heart rate, prompting a more in-depth evaluation.

VSD 94

VSD Aortic valve Open-Heart Surgery Aortic 94

Dr. Smith's ECG Blog

MARCH 3, 2025

There are no Q-waves to suggest old inferior MI, or inferior aneurysm as the etiology of the ST Elevation. Smith : I would say this STE with T-wave inversion (suggesting reperfusion) is "between" active and reperfused inferior OMI, and with persistent symptoms or instability, it is active and acute until proven otherwise.

Tachycardia 74

Tachycardia Pulmonary Chest Pain Stenosis 74