Stroke Journal

FEBRUARY 1, 2024

Introduction:Cerebral vasospasm is a major cause of morbidity and mortality after aneurysmal subarachnoid hemorrhage (aSAH). Transcranial doppler (TCD) ultrasound was measured pre-IAT (D0) and at D+1 and D+2 post-IAT. Stroke, Volume 55, Issue Suppl_1 , Page AWP194-AWP194, February 1, 2024.

Angioplasty 40

Angioplasty Aneurysm Ultrasound Hemorrhage 40

Dr. Smith's ECG Blog

JULY 18, 2014

If detected early by ultrasound, the patient can be saved. Our own Dave Plummer of HCMC reported on survival of 2 of 6 patients with STEMI who had free wall myocardial rupture diagnosed by presence of hemopericardium on bedside ultrasound in the ED.(3) 3) Oliva et al. (4) Bedside echo may detect these in a timely way.

STEMI 52

STEMI Pericarditis Myocardial Infarction Cardiogenic Shock 52

Dr. Smith's ECG Blog

JANUARY 9, 2023

Repeat CT angio chest (not CT coronary, unclear what protocol) showed possible LAD aneurysm and thrombus. Finally, coronary angiography was performed (at least 5 days after presentation) which confirmed LAD aneurysm with large thrombus burden, TIMI 0 flow, thrombectomy performed. Beware a negative Bedside ultrasound.

Chest Pain 52

Chest Pain Aneurysm STEMI Thrombosis 52

Dr. Smith's ECG Blog

OCTOBER 17, 2024

I would do bedside ultrasound to look at the RV, look for B lines as a cause of hypoxia (which would support OMI, and argue against PE), and if any doubt persists, a rapid CT pulmonary angiogram. As for the ECG, it could represent OMI, but RBBB is also a clue that it may be PE. The patient had a protracted hospitalization and did not survive.

Chest Pain 75

Chest Pain STEMI Pulmonary Embolism 75

Dr. Smith's ECG Blog

SEPTEMBER 16, 2015

An elderly patient with a ruptured abdominal aortic aneurysm: Formal ECG Interpretation (final read in the chart!) : "Inferior ST elevation, lead III, with reciprocal ST depression in aVL." A bedside ultrasound was done by the emergency physician, using Speckle Tracking. What do you think? Unfortunately, that video is unavailable.

STEMI 40

STEMI Chest Pain Cardiac Arrest Stents 40

Dr. Smith's ECG Blog

MAY 19, 2020

The patient's heart had significant recovery: Echo : Estimated LVEF 32%, apical wall motion abnormality with diastolic distortion (LV aneurysm), suggestive of old MI. The authors recommend using optical coherence tomography or intravascular ultrasound imaging in patients with evidence of nonobstructive CAD by angiogram.

Defibrillator 52

Defibrillator Circulation Plaque Cardiac Arrest 52

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. These ultrasounds confirm LAD occlusion. What's the story?"

STEMI 40

STEMI Chest Pain Ischemia Aneurysm 40

Dr. Smith's ECG Blog

JANUARY 6, 2023

A CT was completed to rule out dissection, PE, or aneurysm, and this was unremarkable. Smith comment: Point of Care ultrasound is not adequate to rule out wall motion abnormality; moreover, diffuse subendocardial ischemia often has no wall motion abnormality because the epicardium is still contracting. mg/dL, K 3.5 Abstract 556.

Chest Pain 52

Chest Pain Ischemia Myocardial Infarction ICU 52

ECG Cases

MARCH 8, 2021

Rob Simard discusses one of the most important uses of POCUS in the ED, and that is for AAA. He reviews the literature on the accuracy of POCUS for AAA as well as demonstrates the limitations and the common pitfalls in this POCUS Cases video.

Ultrasound 52

Ultrasound Aneurysm Aortic 52

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Among the sequelae observed with an IE diagnosis, acute ischemic stroke (AIS), subarachnoid hemorrhage (SAH), intracerebral hemorrhage (ICH), vasculitis, septic emboli, cerebral abscess, and infectious intracranial aneurysms (IIA) continue to complicate overall management of this disease.

Inpatient 40

Inpatient Hemorrhage Aneurysm Ultrasound 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. Aortic Dissection, Valvular (especially Aortic Stenosis), Tamponade. Most physicians will automatically be worried about these symptoms. orthostatic vitals b.

Arrhythmia 52

Arrhythmia Outcomes Risk Factors Chest Pain 52

Dr. Smith's ECG Blog

DECEMBER 3, 2024

Case continued A bedside cardiac ultrasound revealed grossly preserved left ventricular function, no appreciable wall motion abnormality, pericardial effusion, or obvious valvular abnormality. The terminal part of the T-wave is inverted in lead III, and reciprocally terminally upright in lead aVL. Another EKG was also obtained.

Catheterization Laboratory 112

Catheterization Laboratory STEMI Blog Ischemia 112

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. I suspect pulmonary edema, but we are not given information on presence of B-lines on bedside ultrasound, or CXR findings. However, there is also significant tachycardia , with heart rate of 116, and known hypoxia.

Tachycardia 74

Tachycardia Pulmonary Chest Pain Stenosis 74