Remove Angina Remove Chest Pain Remove Plaque
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Acute chest pain in a young man with low cardiovascular risk profile

Heart BMJ

Clinical introduction Vignette A man in his 40s presented to our emergency department with sudden onset of severe central chest pain radiating to his left arm. There was no antecedent angina. The left system showed no disease in the left main stem, but mild plaque disease in the dominant left circumflex artery.

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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

A 50-something male with hypertension and 20- to 40-year smoking history presented with 1 week of stuttering chest pain that is worse with exertion, which takes many minutes to resolve after resting and never occurs at rest. At times the pain does go to his left neck. It is a ssociated with mild dyspnea on exertion.

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Why is the angiogram normal?

Dr. Smith's ECG Blog

He also complained of intermittent mild chest pain radiating into into both shoulders and his back, as well as occasional unexplained sweating. In addition, his cardiologist suspected vasospastic angina and therefore started amlodipine. He had no further chest pain. The name is self-explanatory.

Angina 71
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Dynamic OMI ECG. Negative trops and negative angiogram does not rule out coronary ischemia or ACS.

Dr. Smith's ECG Blog

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 pathologist may see a plaque that constitutes, for example, 50% of the cross-sectional area.

Ischemia 119
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An undergraduate who is an EKG tech sees something. The computer calls it completely normal. How about the physicians?

Dr. Smith's ECG Blog

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.

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The Hidden Toll of Chronic Stress on Your Heart Health

MIBHS

Sustained inflammation can damage your blood vessels, leading to atherosclerosis (plaque buildup) and increasing your risk of heart attack and stroke. This can lead to chest pain (angina) and increase your risk of heart attack or stroke, especially if you already have underlying heart disease.

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Understanding Coronary Circulation: The Steps that Keep Your Heart Pumping

MIBHS

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. Any interruption in this process can result in serious consequences.