Remove Angina Remove Embolism Remove Ischemia
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American College of Cardiology ACC.24 Late-breaking Science and Guidelines Session Summary

DAIC

ET Main Tent (Hall B1) This session offers more insights from key clinical trials presented at ACC.24 24 and find out what it all means for your patients.

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

Dr. Smith's ECG Blog

A middle-aged woman had intermittent angina for 48 hours, then onset of constant, crushing chest pain for 1.5 Both of these are very suggestive of " No-Reflow ," or poor microvascular reperfusion due to downstream embolization of microscopic platelet-fibrin aggregates. hours when she called 911.

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Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting."

Dr. Smith's ECG Blog

Takotsubo is a sudden event, not one with crescendo angina. 9 This dissociation between the degree of stenosis and the propensity to provoke an acute coronary syndrome helps to explain why myocardial infarction often occurs without being heralded by the demand-induced symptoms of angina that would result from a high-grade stenosis.

Plaque 52
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Are there hyperacute T-waves? And how can we know?

Dr. Smith's ECG Blog

Watch what happends as the heart recovers from its episode of ischemia. The ECG shows inferior ischemia. By itself seeing this ECG pattern does not necessarily mean that the patient has a pulmonary embolism. Are the T-waves in leads I and II hyperacute? Hard to tell. How can we know? By the evolution of the ECG!

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Can you localize the culprit lesion on angiogram without taking ECG findings into account?

Dr. Smith's ECG Blog

There is low voltage in the precordium which always makes reading ischemia harder. In ACS, chest pain is the warning sign of ongoing ischemia. Smith : As Willy says, and as we've said many times before, morphine will resolve pain without resolving ischemia. ECG 1 What do you think? To me, this ECG is not diagnostic.