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Interventional management involved performing percutaneous transluminal coronary angioplasty using balloon dilation on both the left main coronary artery and its ostium. The patient experienced resolution of symptoms, and ventricular premature beats disappeared on electrocardiogram monitoring.
Electrocardiogram (ECG) showed a prominent S wave in the left-sided leads and a prominent R wave in the right-sided chest leads, suggesting dextrocardia. After guidewire crossing, balloon angioplasty was performed, and a drug-eluting stent was deployed. His vital signs were normal, and the physical examination was unremarkable.
These tests may include: Electrocardiogram (ECG) : Records the electrical activity of your heart. A heart check-up is a comprehensive evaluation of your cardiovascular health. It typically includes a physical examination, medical history review and diagnostic tests. Echocardiogram : Uses sound waves to create images of your heart.
Refractory ischemic chest pain continued and trop increased to 160,000ng/L, with subtle convex anterior ST elevation: The patient was brought back to cath lab for stenting of LAD and balloon angioplasty to OM. Clin Cardiol 2022 4. Herman, Meyers, Smith et al. Eur Heart J Digital Health 2024 5. McLaren and Smith.
Determinants and prognostic implications of persistent ST-segment elevation after primary angioplasty for acute myocardial infarction: importance of microvascular reperfusion injury on clinical outcome. Clinical value of 12-lead electrocardiogram after successful reperfusion therapy for acute myocardial infarction.
New electrocardiographic criteria for posterior wall acute myocardial ischemia validated by a percutaneous transluminal coronary angioplasty model of acute myocardial infarction. 3 However, 22-39% of patients experiencing posterior MI who have greater than or equal to 0.5mm STE in the posterior leads do not demonstrate STD in V1-V3.
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. Updates on the Electrocardiogram in Acute Coronary Syndromes.
New electrocardiographic criteria for posterior wall myocardial ischemia validated by percutaneous transluminal coronary angioplasty model of acute myocardial infarction. About half of patients receiving elective balloon angioplasty of the circumflex will show posterior STE ≥ 1mm. (8-12) Neth Heart J. 2007; 15: 16-21. Wung SF, Drew BJ.
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