Dr. Smith's ECG Blog

MARCH 9, 2013

A stent was placed. In my experience, all Wellens' with significant myocardial infarction have evolution from type A waves to type B waves over 6-24 hours' time , so that the presence of type A or type B waves, I believe, are simply a matter of the timing of recording and the rapidity of evolution. de Zwaan C., Wellens H.J.J.,

Chest Pain 52

Chest Pain Myocardial Infarction Ischemia Angina 52

Dr. Smith's ECG Blog

OCTOBER 26, 2011

An open 90% LAD was stented. Here is the ECG the next AM: There was so little infarction that there are lateral, but no anterior reperfusion T-waves (normally, there would be Wellens' type waves after LAD reperfusion). Here is some older but very interesting literature on TIMI myocardial perfusion grade and ST resolution : 1.

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STEMI Chest Pain Myocardial Infarction Angioplasty 52

Dr. Smith's ECG Blog

NOVEMBER 19, 2014

A male in late middle age with a history of RCA stent 8 years prior complained of chest pain. 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

JANUARY 1, 2013

The OM-1 was opened and stented, then the LAD was stented 3 days later. The acute infarct-related artery was off the circumflex and the affected wall was posterior (STEMI). The LAD had a 75% proximal lesion that by fractional flow reserve was hemodynamically significant. The posterior leads were falsely negative.

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STEMI Ischemia Chest Pain Myocardial Infarction 52

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

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. Smith's ECG Blog

MARCH 13, 2023

It was opened and stented. The Cath lab was activated. Repeat ECG while waiting for cath team, t = 56 min after arrival: It is getting worse Angiogram showed 99% acute proximal LAD thrombosis. Peak trop ＞ 50,000 ng/L Formal Bubble contrast echo Severe LV systolic dysfunction.

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Chest Pain Myocardial Infarction Angioplasty Thrombosis 52

Dr. Smith's ECG Blog

OCTOBER 22, 2024

Successful primary angioplasty of the mid-circumflex artery towards the main marginal branch with the implantation of a drug-eluting stent. Immediate and early percutaneous coronary intervention in very high-risk and high-risk non-ST segment elevation myocardial infarction patients. Good angiographic result.

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Chest Pain STEMI Myocardial Infarction Angioplasty 66

Dr. Smith's ECG Blog

SEPTEMBER 29, 2018

The lesion was intervened on with balloon angioplasty and had subsequent TIMI 3 flow. It was thought to be an in stent restenosis and thrombosis from a DES placed in the same region 6 months prior. There was initially TIMI 0 flow. His troponin I peaked at 97 ng/mL (very large MI!). What can we learn?

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Chest Pain Myocardial Infarction Cardiac Arrest Ischemia 52

Dr. Smith's ECG Blog

MAY 10, 2023

ng/mL This single initial troponin at this level, in the context of chest pain, is high enough to be diagnostic of acute myocardial infarction. INTERVENTION * Successful angioplasty and stenting (drug eluting) of the mid LAD * Successful angioplasty of the ostial 1st diagonal Learning points: 1.

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Coronary Angiogram Chest Pain Stenosis STEMI 52

Dr. Anish Koka

MAY 16, 2023

In their haste to hyperventilate about MINOCA, the authors don’t highlight the high percentage of cardiac interventions that are needed in patients with conventional, common epicardial disease - 80% need a coronary stent and 10% need open heart surgery. Women also had more cardiovascular risk factors, including hypertension (66.6%

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Chest Pain Coronary Artery Disease Cancer Heart Attack 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 attacks Heart Attack Blood Pressure Myocardial Infarction 52

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

Dr. Smith's ECG Blog

APRIL 2, 2025

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. A stent was placed.

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Chest Pain STEMI Myocardial Infarction Stents 76