Open Heart

AUGUST 25, 2024

Background On the one hand, the primary coronary slow flow phenomenon (CSFP) can cause recurrence of chest pain, prompting medical examinations and further healthcare costs, while on the other hand, it can lead to myocardial infarction, ventricular arrhythmia and sudden cardiac death.

Sudden Cardiac Death 40

Sudden Cardiac Death Angina Chest Pain Myocardial Infarction 40

Dr. Smith's ECG Blog

JUNE 28, 2018

He had suffered a couple bouts of typical chest pain in the last 24 hours. This ECG (ECG #3) was recorded immediately after the last episode of pain spontaneously resolved. The pain had lasted about one hour. Electrocardiographic diagnosis of reperfusion during thrombolytic therapy in acute myocardial infarction.

Chest Pain 52

Chest Pain Myocardial Infarction STEMI Article 52

Circulation

NOVEMBER 11, 2024

The confirmation cohort, which was obtained from the National Institute of Health, consisted of 3315 patients with normal Bruce protocol treadmill stress test results in the Prospective Multicenter Imaging Study for Evaluation of Chest Pain (PROMISE) Trial. RHR and peak exercise heart rates (PHR) were tabulated. x age in years).Results:The

Exercise 40

Exercise Chest Pain Myocardial Infarction Bradycardia 40

MIBHS

OCTOBER 15, 2024

Without oxygen, the cells would quickly die, leading to a heart attack (myocardial infarction). For example, if a coronary artery becomes blocked due to plaque buildup (a condition known as coronary artery disease), the heart muscle may not receive enough oxygen, leading to chest pain (angina) or, in more severe cases, a heart attack.

Circulation 52

Circulation Heart attacks Heart Attack Chest Pain 52

Dr. Smith's ECG Blog

MAY 20, 2024

A 63 year old man with a history of hypertension, hyperlipidemia, prediabetes, and a family history of CAD developed chest pain, shortness of breath, and diaphoresis after consuming a large meal at noon. He called EMS, who arrived on scene about two hours after the onset of pain to find him hypertensive at 220 systolic.

Chest Pain 125

Chest Pain Blood Pressure Ischemia STEMI 125

Dr. Smith's ECG Blog

SEPTEMBER 18, 2024

This confirms that the pain was ischemia and is now resovled. Thus, it has recently become generally accepted that most plaque ruptures resulting in myocardial infarction occur in plaques that narrow the lumen diameter by 40% of the arterial cross section may be involved by plaque. The i nitial hs troponin I returned 75%.

Ischemia 119

Ischemia Plaque Stenosis Myocardial Infarction 119

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. So this is indeed diagnostic of myocardial infarction. Not immediately, at least, because this is NOT diagnostic of ACUTE (occlusion) myocardial infarction (Acute OMI). Here is his initial ECG: What do you think?

Angina 52

Angina Stents Stent Aneurysm 52

Dr. Anish Koka

MAY 16, 2023

This means that at every age, the probability a man complaining of chest pain has significant underlying coronary disease as a cause of this chest pain is much higher than a woman complaining of chest pain. The results of this dataset by age and gender follow.

Chest Pain 52

Chest Pain Coronary Artery Disease Cancer Heart attacks 52

DAIC

MAY 14, 2024

The impact of this narrowing can ultimately result in angina (chest pain), which has been shown to double the risk of major cardiovascular events,1 as well as myocardial infarction ( heart attack ) or even death. Use Heart to Act on Angina. Available at: [link]. Accessed May 2024.

Coronary Artery Disease 111

Coronary Artery Disease Interventional Cardiology Innovation Physiology 111

Dr. Smith's ECG Blog

APRIL 18, 2024

Written by Jesse McLaren A 70 year old with prior MIs and stents to LAD and RCA presented to the emergency department with 2 weeks of increasing exertional chest pain radiating to the left arm, associated with nausea. 1] European guidelines add "regardless of biomarkers". But only 6.4% Clin Cardiol 2022 4. Herman, Meyers, Smith et al.

STEMI 120

STEMI Chest Pain Myocardial Infarction Stents 120

DAIC

FEBRUARY 29, 2024

ET Main Tent (Hall B1) - A Double-blind, Randomized Placebo Procedure-controlled Trial of an Interatrial Shunt in Patients with HFrEF and HFpEF: Principal Results From the RELIEVE-HF Trial - Empagliflozin After Acute Myocardial Infarction: Results of the EMPACT-MI Trial - CSL112 (Apolipoprotein A-I) Infusions and Cardiovascular Outcomes in Patients (..)

Aortic valve 103

Aortic valve Myocardial Infarction Aortic Blood Pressure 103

Dr. Smith's ECG Blog

NOVEMBER 3, 2023

A man in his 70s with past medical history of hypertension, dyslipidemia, CAD s/p left circumflex stent 2 years prior presented to the ED with worsening intermittent exertional chest pain relieved by rest. This episode of chest pain began 3 hours ago and was persistent even at rest. Troponin was ordered. Eur J Emerg Med.

Chest Pain 83

Chest Pain Cardiogenic Shock Ischemia Myocardial Infarction 83

Dr. Sanjay Gupta

DECEMBER 19, 2022

The term MINOCA stands for Myocardial infarction with non-obstructive coronary arteries. A 50-year-old lady was admitted to my hospital with crushing chest tightness. Cardiac Causes Myocarditis – an infection of the heart may cause damage to the heart muscle and cause chest pain.

Heart attacks 40

Heart attacks Heart Attack Blood Clot Chest Pain 40

Dr. Smith's ECG Blog

MAY 10, 2023

A 34 yo woman with a history of HTN, h/o SVT s/p ablation 2006, and 5 months post-partum presented with intermittent central chest pain and SOB. She had one episode of pain the previous night and two additional episodes early on morning the morning she presented. Deep breaths are painful and symptoms come and go.

Coronary Angiogram 52

Coronary Angiogram Chest Pain Stenosis STEMI 52

Dr. Smith's ECG Blog

MARCH 9, 2013

This male in his 40's had been having intermittent chest pain for one week. He awoke from sleep with crushing central chest pain and called ems. EMS recorded a 12-lead, then gave 2 sublingual nitros with complete relief of pain. Wellens' syndrome represents a state of reperfusion of the infarct related artery 2.

Myocardial Infarction 52

Myocardial Infarction Chest Pain Ischemia Angina 52

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

This patient, who is a mid 60s female with a history of hypertension, hyperlipidemia and GERD, called 911 because of chest pain. A mid 60s woman with history of hypertension, hyperlipidemia, and GERD called 911 for chest pain. It is also NOT the clinical scenario of takotsubo (a week of intermittent chest pain).

Plaque 52

Plaque Chest Pain Thrombosis Stenosis 52

Dr. Smith's ECG Blog

JANUARY 5, 2024

So there is probability of myocardial injury here (and because it is in the correct clinical setting, then myocardial infarction.) Thus, the patient does not (yet) get a formal diagnosis of MI and must be called unstable angina unless further troponins return above the 99th percentile. Repeat ECG at that time is shown.

Angina 111

Angina Plaque Document Stents 111

Dr. Smith's ECG Blog

OCTOBER 24, 2018

Therefore, this does not meet the definition of myocardial infarction ( 4th Universal Definition of MI ), which requires at least one troponin above the 99% reference range. This was clearly severe subepicardial ischemia causing ST Elevation, but it was not of a long enough duration to result in measurable infarct.

STEMI 52

STEMI Angina Myocardial Infarction Plaque 52

Dr. Smith's ECG Blog

DECEMBER 19, 2018

A middle-aged woman had an acute onset of chest pain and dyspnea. The pain had almost resolved by the time an ECG was obtained in the ED: Here is the computer diagnosis What do you think? ng/ml , a three-fold increase from troponin #2, also confirming acute myocardial infarction. It was not normal!

Chest Pain 52

Chest Pain Ischemia Myocardial Infarction Angina 52

Dr. Smith's ECG Blog

MARCH 6, 2019

A middle-aged woman with history of hypertension presented to another hospital approximately 2 hours after onset of chest pain and shortness of breath. Early Continuous ST Segment Monitoring in Unstable Angina: Prognostic Value Additional to the Clinical Characteristics and the Admission Electrocardiogram. mm STE in V1 and 1.5-2.0

STEMI 52

STEMI Chest Pain Ischemia Myocardial Infarction 52

Dr. Smith's ECG Blog

JULY 21, 2019

They were recorded 12 minutes apart: "Hey Steve, 30-something with one week of chest pain, mostly right-sided, better with sitting up.": I do not think this is acute occlusion myocardial infarction (OMI). This history of a week of constant chest pain is also much more suggestive of myocarditis.

Chest Pain 52

Chest Pain Myocardial Infarction Pericarditis Angina 52

Dr. Smith's ECG Blog

AUGUST 9, 2019

At the bottom of the post, I have re-printed the section on aVR in my article on the ECG in ACS from the Canadian Journal of Cardiology: New Insights Into the Use of the 12-Lead Electrocardiogram for Diagnosing Acute Myocardial Infarction in the Emergency Department Case 1. Widimsky P et al. This was a 100% acute LM occlusion.

Myocardial Infarction 52

Myocardial Infarction Ischemia STEMI Cardiogenic Shock 52

Coronary Artery Disease Journal

JULY 7, 2024

Background In myocardial infarction with nonobstructive coronary arteries (MINOCA), there are limited patient-level data on outcomes by sex and race. Methods Patients admitted to a single center with acute myocardial infarction (MI) between 1 January 2012 and 31 December 2018, were identified by chart and angiographic review.

Myocardial Infarction 40

Myocardial Infarction Chest Pain Angina Outcomes 40

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 Appearance of abnormal Q waves early in the course of acute myocardial infarction: implications for efficacy of thrombolytic therapy. hours when she called 911. These do NOT indicate late, subacute MI.

Myocardial Infarction 52

Myocardial Infarction Pericarditis Angina STEMI 52

Dr. Smith's ECG Blog

FEBRUARY 10, 2022

In the STEMI/NSTEMI dichotomy, NSTEMI is supposed to mean non-occlusive myocardial infarction, but this patient had transient Occlusion MI that was at risk for re-occlusion (like ‘transient STEMI’). Impact of total occluson of culprit artery in acute non-ST elevation myocardial infarction: a systemic review and meta-analysis.

STEMI 40

STEMI Myocardial Infarction Chest Pain Angina 40

Dr. Smith's ECG Blog

JANUARY 1, 2013

A middle aged male with no h/o CAD presented with one week of crescendo exertional angina, and had chest pain at the time of the first ECG: Here is the patient's previous ECG: Here is the patient's presenting ED ECG: There is isolated ST depression in precordial leads, deeper in V2 - V4 than in V5 or V6. BP was 160/100.

STEMI 52

STEMI Ischemia Chest Pain Myocardial Infarction 52

Dr. Smith's ECG Blog

JULY 31, 2018

This is diagnostic of myocardial infarction. In middle age women, it accounts for 22-35% of all ACS presentations 1,3 , and the reported incidence of ST-elevation myocardial infarction in this subset of patients is variable, but estimated to be between 24-50% 4. She felt more comfortable being admitted. Int J Cardiol.

SCAD 52

SCAD Chest Pain Myocardial Infarction Ischemia 52

Cardiometabolic Health Congress

MAY 10, 2024

Major findings from the INTERHEART study reveal that stress is more common among cases of acute myocardial infarction (AMI) compared to controls. As a result, psychological stress is highly associated with CVD and cardiometabolic disease in women. Combining behavioral and pharmacological treatment is most effective.

Coronary Artery Disease 59

Coronary Artery Disease Obesity Chest Pain Ischemia 59