Journal of Cardiothoracic Surgery

DECEMBER 18, 2024

Six months following modified Bentall procedure a patient presented with angina and acute ST depression. CT coronary angiogram revealed severe narrowing of the left main coronary artery. Minimal invasive off p.

Coronary Artery Bypass Graft 52

Coronary Artery Bypass Graft Coronary Angiogram Angina Stenosis 52

Dr. Smith's ECG Blog

SEPTEMBER 18, 2024

Since the pathologist does not know the original cross-sectional area of the artery or the amount of compensatory enlargement of the artery from evaluation of a single cross section of the artery at a site of stenosis, the degree of luminal narrowing of that segment cannot be determined. These are typical findings at sites of plaque rupture.

Ischemia 121

Ischemia Plaque Stenosis Myocardial Infarction 121

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. Culprit Lesion: Angiographically indeterminate 50% stenosis in the proximal OM2 was assessed further with instantaneous wave free ratio (iFR) of 0.96, which is normal (see below for description of iFR*).

Angina 52

Angina Stents Stent Aneurysm 52

Dr. Smith's ECG Blog

APRIL 22, 2024

Patient is pain free and clearly has Wellens' syndrome: 1) pain free episode following an episode of angina, typical Pattern A (biphasic, terminal T-wave inversion with an initial upsloping ST Segment) findings, preserved R-waves. Angiography : --Culprit for the patient's unstable angina/Wellen syndrome is a ruptured plaque in the mid LAD. --As

Chest Pain 117

Chest Pain Myocardial Infarction Anatomy Angina 117

Heart BMJ

FEBRUARY 23, 2024

However, revascularisation of coronary stenosis, which induces myocardial ischaemia, has demonstrated better outcome than OMT alone. Patients with diffuse disease showed a twofold risk of residual angina after percutaneous coronary intervention (PCI) than those with focal disease.

Coronary Artery Disease 53

Coronary Artery Disease Physiology Coronary Artery Bypass Graft Quality of Life 53

EMS 12-Lead

JULY 24, 2023

Given the consistency of the clinical profile with typical angina, associated risk factors, and abnormal ECG findings, a cardiology consult was promptly requested. Aortic Stenosis f. Left Main stenosis (not thrombosed) c. Aortic Stenosis [No Hx syncope, and no systolic murmur] f. Left Main stenosis (not thrombosed) c.

Angina 52

Angina Ischemia Coronary Angiogram Stenosis 52

Dr. Smith's ECG Blog

JANUARY 5, 2024

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. On the basis of unresolved angina, cardiology decided to perform rescue PCI. The LAD has diffuse disease with a few areas of moderate stenosis but no flow-limiting lesions.

Angina 120

Angina Plaque Document Stents 120

Open Heart

MARCH 29, 2024

Background Aortic stenosis is a life-limiting condition for which transcatheter aortic valve implantation (TAVI) is an established therapy. Subsidiary outcomes included patient angina and breathlessness scores. CAD at the time of TAVI also did not alter breathlessness or angina scores before/after TAVI (p>0.05).

Coronary Artery Disease 52

Coronary Artery Disease Aortic valve Aortic Outcomes 52

Dr. Smith's ECG Blog

DECEMBER 19, 2023

link] A 62 year old man with a history of hypertension, type 2 diabetes mellitus, and carotid artery stenosis called 911 at 9:30 in the morning with complaint of chest pain. This is written by Willy Frick, an amazing cardiology fellow in St. He described it as "10/10" intensity, radiating across his chest from right to left.

Plaque 127

Plaque Angina Blog Stents 127

Circulation: Cardiovascular Interventions

JANUARY 20, 2025

The primary end point was minimal lumen area at 6-month follow-up.RESULTS:Following Magmaris BRS implantation, minimal lumen area (6.41.6 versus 6.31.5 mm2;P=0.65), mean scaffold area (7.81.5 versus 7.51.7 mm2;P=0.37), and mean lumen area (8.01.6 versus 7.72.1

Stenosis 40

Stenosis Ultrasound Stents Stent 40

Dr. Smith's ECG Blog

DECEMBER 14, 2018

This appears to be a classic Wellens' ECG, Pattern A, with terminal T-wave inversion in V2-V4, preserved R-waves, and it appears to be Wellens' syndrome, as it occurred after resolution of typical angina pain. When this happens, troponins are negative, there is no wall motion abnormality, and it is true unstable angina.

Chest Pain 52

Chest Pain Angina Ischemia Stenosis 52

Dr. Smith's ECG Blog

MAY 20, 2024

If it is angina, lowering the BP with IV Nitroglycerine may completely alleviate the pain and the (unseen) ECG ischemia. Or is it a very tight stenosis that does not allow enough flow to perfuse myocardium that has a high oxygen demand from severely elevated BP? The ST depressions in I and aVL have resolved.

Chest Pain 125

Chest Pain Blood Pressure Ischemia STEMI 125

Coronary Artery Disease Journal

MAY 2, 2024

Methods We retrospectively enrolled 237 patients who underwent elective coronary angiography (CAG) for stable angina or positive stress test results >1 year after CABG. The SVGD was defined as presence of at least 50% stenosis in at least 1 SVG. The patients were divided into two groups; SVGD (+) patients and SVGD (−) patients.

Coronary Artery Bypass Graft 40

Coronary Artery Bypass Graft Angina Atherosclerosis Stenosis 40

Cardiology Update

APRIL 9, 2024

SMART 4 ( NCT04722250 ) studied patients with severe aortic stenosis and a small aortic annulus who underwent transcatheter aortic valve replacement (TAVR). The primary endpoint consisted of a composite of all-cause mortality, MI, stroke, coronary revascularization, or hospitalization for unstable angina. vs. 6.2%) and stroke (2.9%

Angina 52

Angina Myocardial Infarction Aortic valve Coronary Artery Disease 52

Dr. Smith's ECG Blog

MARCH 9, 2013

When there is extremely brief ischemia, as in this case , or this case , it may entirely reverse, especially in unstable angina (negative troponins). Angiographic and clinical characteristics of patients with unstable angina showing an ECG pattern indicating critical narrowing of the proximal LAD coronary artery. Lessons: 1.

Chest Pain 52

Chest Pain Myocardial Infarction Ischemia Angina 52

Circulation

NOVEMBER 11, 2024

Notably, the LAD had multiple aneurysmal segments and areas of eccentric stenosis upto 90%.Multislice However some patients can develop heart failure, angina, and arrhythmia due to significant intracardiac shunt or coronary steal phenomenon. CCF can be congenital or acquired and has many variations. It is often clinically silent.

Coronary Artery Bypass Graft 40

Coronary Artery Bypass Graft ACE Inhibitor Coronary Angiogram Aneurysm 40

Circulation

NOVEMBER 11, 2024

Patients with dextrocardia present a diagnostic challenge, particularly in the context of acute coronary syndrome.Case Presentation:A 49-year-old male with a medical history of dextrocardia, hypothyroidism, dyslipidemia and hypertension was referred to a cardiologist by his primary physician due to a 3-week history of unstable angina.

Coronary Artery Disease 40

Coronary Artery Disease Angioplasty Anatomy Angina 40

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

Takotsubo is a sudden event, not one with crescendo angina. 1-4 Surprisingly, serial angiographic studies have revealed that the plaque at the site of the culprit lesion of a future acute myocardial infarction often does not cause stenosis that, as seen on the antecedent angiogram, is sufficiently severe to limit flow.

Plaque 52

Plaque Chest Pain Thrombosis Stenosis 52

Dr. Anish Koka

MAY 16, 2023

Typical angina was defined as a symptom complex that includes substernal chest pressure or pain that was made worse with exertion/emotional stress, and relieved by rest or nitroglycerin. Atypical angina is classified as having any two of the three symptoms, and non-anginal pain any one of the three symptoms.

Chest Pain 52

Chest Pain Coronary Artery Disease Cancer Heart attacks 52

DAIC

FEBRUARY 29, 2024

24: Joint American College of Cardiology/Journal of the American College of Cardiology Late-Breaking Clinical Trials (Session 402) Saturday, April 6 9:30 – 10:30 a.m.

Aortic valve 103

Aortic valve Myocardial Infarction Aortic Blood Pressure 103

Dr. Smith's ECG Blog

DECEMBER 7, 2023

Serial EKG is very high yield diagnostic test in patients with stuttering angina. If a patient’s presentation is suggestive of stress cardiomyopathy, the onus is on the treating clinician to rule out other causes including OMI. EKG 3 is diagnostic for developing re-occlusion, and EKG 4 proves that the nitrates relieved the ischemia. =

SCAD 124

SCAD Ischemia Coronary Artery Disease Cardiomyopathy 124

Dr. Smith's ECG Blog

JUNE 18, 2011

The patient had a critical LAD stenosis. Tight proximal LAD stenosis explains STE in precordial leads and I and aVL. I did not include the prehospital because it is identical to the first ED ECG: Self explanatory, no? All troponins were u ndetectable (less than 0.04 Flow had spontaneously been restored, perhaps aided by nitroglycerin.

STEMI 52

STEMI Pericarditis Hospital Aneurysm 52

Dr. Smith's ECG Blog

MAY 10, 2023

LAD plaque with 0-25 percent stenosis. The LAD has moderate 40% ostial-proximal LAD stenosis and severe 90% mid LAD stenosis involving first diagonal branch. --The If trops are negative and there is <50% stenosis, then the patient is safe for discharge, even if the HEART score or EDACS score are elevated.

Coronary Angiogram 52

Coronary Angiogram Chest Pain Stenosis STEMI 52

Dr. Smith's ECG Blog

AUGUST 9, 2019

Beware crescendo angina in patient with known CAD ST Elevation in aVR Case 7. baseline LVH, demand ischemia secondary to respiratory failure, aortic stenosis, hemorrhagic shock). found that only 23% of patients with the aVR STE pattern had any LM disease (fewer if defined as ≥ 50% stenosis). This was a 100% acute LM occlusion.

Myocardial Infarction 52

Myocardial Infarction Ischemia STEMI Cardiogenic Shock 52

Dr. Smith's ECG Blog

JUNE 28, 2018

Characteristic electrocardiographic pattern indicating a critical stenosis high in left anterior descending coronary artery in patients admitted because of impending myocardial infarction. Am Heart J. 1982 Apr;103(4 Pt 2):730-6. de Zwaan C et al.

Chest Pain 52

Chest Pain Myocardial Infarction STEMI Article 52

Dr. Smith's ECG Blog

JULY 3, 2018

Here are the images from the cardiac cath: Mid to distal-LAD in-stent stenosis with 100% occlusion and TIMI flow 0 LAD post-DES placement with TIMI 3 flow The amount of territory supplied by this vessel becomes obvious here (and goes on for a few more frames below this still).

Pericarditis 52

Pericarditis Chest Pain Stents Stent 52

Journal of the American Heart Association

FEBRUARY 27, 2024

We evaluated the primary outcome (cardiovascular death, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest) and other end points, by sex, in 1168 (22.6%) women and 4011 (77.4%) men. of invasive‐assigned men, and no ≥50% stenosis in 12.3% of invasive‐assigned men;P&lt;0.001).

Ischemia 45

Ischemia Coronary Artery Disease Myocardial Infarction Outcomes 45

Heart BMJ

JANUARY 13, 2025

Angiograms were examined for luminal stenosis in each segment of the SYNTAX coronary model. Cumulative plaque burden was quantified using the Gensini score, which incorporated both the number of diseased coronary segments and stenosis severity. –11.0)), vasospastic angina (VSA) (4.5 (2.0–10.0)),

Plaque 52

Plaque Coronary Artery Disease Angina Physiology 52

Frontiers in Cardiovascular Medicine

MARCH 5, 2025

He was diagnosed with an unstable angina, and coronary angiography showed near-total in-stent occlusion of the previously placed stent protruding into the aorta. Coronary angiography revealed tight stenosis at the ostial left anterior descending artery with a previous stent deployed from the left main to the circumflex artery.

Stents 52

Stents Stent Chest Pain Myocardial Infarction 52

Dr. Smith's ECG Blog

DECEMBER 6, 2024

Angiogram: Severe two-vessel coronary artery disease of a left dominant system including 70 to 80% stenosis involving the distal left main/bifurcation. The estimated left ventricular ejection fraction is 64%. There is no left ventricular wall motion abnormality identified. The ECG shows inferior ischemia.

Coronary Artery Bypass Graft 107

Coronary Artery Bypass Graft Ischemia Chest Pain Stenosis 107