Dr. Smith's ECG Blog

APRIL 22, 2024

A comparison of electrocardiographic changes during reperfusion of acute myocardial infarction by thrombolysis or percutaneous transluminal coronary angioplasty. Electrocardiographic diagnosis of reperfusion during thrombolytic therapy in acute myocardial infarction. Am Heart J. 2000;139:430–436. Am J Cardiol.

Chest Pain 118

Chest Pain Myocardial Infarction Anatomy Angina 118

Dr. Smith's ECG Blog

MARCH 9, 2013

I have seen cases of Wellens' syndrome that were ignored because of either negative troponins or normal echo or both and the patient did not get an angiogram and had a bad outcome. Electrocardiographic diagnosis of reperfusion during thrombolytic therapy in acute myocardial infarction. Am Heart J (1989) 117 : pp 657-665.

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Chest Pain Myocardial Infarction Ischemia Angina 52

Dr. Smith's ECG Blog

AUGUST 3, 2017

Electrocardiographic Manifestations: Acute posterior wall myocardial infarction. Posterior myocardial infarction: the dark side of the moon. New electrocardiographic criteria for posterior wall myocardial ischemia validated by percutaneous transluminal coronary angioplasty model of acute myocardial infarction.

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Chest Pain Myocardial Infarction STEMI Ischemia 52

Dr. Smith's ECG Blog

NOVEMBER 19, 2014

It is highly associated with proximal LAD occlusion and bad outcomes. See this article by Widimsky: Primary angioplasty in acute myocardial infarction with right bundle branch block: should new onset right bundle branch block be added to future guidelines as an indication for reperfusion therapy [link]

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Chest Pain Cardiac Arrest Myocardial Infarction Angioplasty 52

Dr. Smith's ECG Blog

OCTOBER 26, 2011

Determinants and prognostic implications of persistent ST-segment elevation after primary angioplasty for acute myocardial infarction: importance of microvascular reperfusion injury on clinical outcome. Relationship of TIMI myocardial perfusion grade to mortality after administration of thrombolytic drugs.

STEMI 52

STEMI Chest Pain Myocardial Infarction Angioplasty 52

Circulation

NOVEMBER 11, 2024

to 10% of percutaneous coronary interventions (PCI), no-reflow is a complication associated with poor outcomes like myocardial infarction extension and death. Circulation, Volume 150, Issue Suppl_1 , Page A4139207-A4139207, November 12, 2024. Background:Occurring in 0.6%

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Myocardial Infarction Angioplasty Pulmonary Arrhythmia 40

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. O'Gara PT, Kushner FG, Ascheim DD, et al.

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Myocardial Infarction Ischemia STEMI Cardiogenic Shock 52

Dr. Smith's ECG Blog

FEBRUARY 8, 2015

There was a good outcome. We believe this represents a form of “toxicomythology” given the millions of doses of beta -blockers administered in the past to patients with hyperadrenergic states, and a paucity of evidence of adverse outcomes (12). This would treat both SVT or sinus tachycardia. Later, he was found to have used cocaine.

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Tachycardia Chest Pain Pharmacology Myocardial Infarction 52

Dr. Smith's ECG Blog

JUNE 18, 2013

Studies show that 30% of NonSTEMI have an occluded infarct artery at the time of angiography done 24 hours after presentation. These patients have worse outcomes: higher mortality, more CHF, higher biomarkers, and worse ejection fractions than the NonSTEMI patients with open arteries. This is because of subtle ECG findings.

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STEMI Chest Pain Myocardial Infarction Webinar 52

Dr. Smith's ECG Blog

MARCH 9, 2023

Read our recent editorial: Hyperacute T-waves Can Be a Useful Sign of Occlusion Myocardial Infarction if Appropriately Defined. Do you think his long term outcome will be as good as if his OMI were recognized appropriately on arrival, 1.5 TIMI flow alone cannot be used as an outcome definition for OMI or STEMI. =

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Chest Pain STEMI Myocardial Infarction Blog 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. Electrocardiographic diagnosis of reperfusion during thrombolytic therapy in acute myocardial infarction. Am Heart J. Am Heart J.

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Chest Pain Myocardial Infarction STEMI Article 52

Dr. Anish Koka

MAY 16, 2023

Soviet biologist Trofim Lysenko famously rejected the objective reality of Mendelian genetics because it clashed with the Marxist philosophy that the environment, not genetics, was the primary determinant of outcomes. But what should matter is outcomes not diagnoses. Physician assessments often misclassify chest pain as nonanginal.

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Chest Pain Coronary Artery Disease Cancer Heart Attack 52

Dr. Smith's ECG Blog

OCTOBER 24, 2019

Spontaneous coronary artery dissection Dissection of a coronary artery may occur in the context of atherosclerosis, or be iatrogennic during angiography or angioplasty. Outcome of our case Once the type 2 SCAD was identified, the heparin drip was stopped. This case occurred 10+ years ago. Lobo et al. The SCAD cases in Lobo et al.

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Chest Pain SCAD STEMI Cardiogenic Shock 52

Dr. Smith's ECG Blog

APRIL 8, 2022

Immediate and early percutaneous coronary intervention in very high-risk and high-risk non-ST segment elevation myocardial infarction patients. Her long term outcome (with very large LAD MI and EF of 30%) is unknown. Otherwise it results in a terrible outcome, as in this case, with devastating permanent loss of myocardium).

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Chest Pain SCAD STEMI Blog 52

Dr. Smith's ECG Blog

APRIL 17, 2023

Full case details and outcomes are below. Next trop 85,528 ng/L (consistent with a massive myocardial infarction), none further measured. Sean Rees MD, written by Pendell Meyers, other case by Sam Ghali and Steve Smith Take a look at these two ECGs below from two patients in the ED, first without any clinical context.

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Chest Pain STEMI Document Ischemia 52

Wellnest

JULY 19, 2023

When one of these arteries becomes completely blocked by a blood clot, it results in a heart attack, also known as MI (Myocardial infarction). When a person experiences a heart attack or myocardial infarction, they may feel chest pain and other symptoms in different parts of their body.

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Heart Attack Heart attacks Blood Pressure Myocardial Infarction 52

Heart BMJ

OCTOBER 28, 2024

The objective of this study was to determine whether PCI is associated with better outcomes, compared with medical therapy (MT) alone. Using the Swedish Coronary Angiography and Angioplasty Registry, we included all patients with CCS undergoing coronary angiography in Sweden between 2010 and 2020.

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Angioplasty Myocardial Infarction Outcomes 59

Frontiers in Cardiovascular Medicine

MARCH 17, 2025

Initial diagnostics indicated non-ST-elevation myocardial infarction, leading to immediate intervention. A combination of balloon angioplasty, stent implantation, and intra-arterial thrombolysis with recombinant tissue plasminogen activator (rt-PA) was employed, resulting in significant thrombus reduction and improved coronary flow.

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Coronary Artery Bypass Graft Thrombolysis Coronary Artery Disease Myocardial Infarction 52