Dr. Smith's ECG Blog

MAY 10, 2023

A CT Coronary angiogram was ordered. Here are the results: --Minimally obstructive coronary artery disease. --LAD No signs for aortic dissection or pulmonary embolus. --"Results were discussed with the ordering physician. A repeat troponin returned at 0.45 ng/mL, consistent with reperfused OMI, or Non-OMI.

Coronary Angiogram 52

Coronary Angiogram Chest Pain Stenosis STEMI 52

Heart BMJ

FEBRUARY 12, 2024

The patient was managed medically and was referred to us in view of worsening symptoms with severe left ventricular dysfunction and moderate aortic regurgitation. The coronary angiogram was normal. Figure 1 (A) Two-dimensional echocardiogram short-axis basal view showing aortic valve; (B) volume-rendered CT aortogram.

Coronary Angiogram 75

Coronary Angiogram Aortic valve Echocardiogram Aortic 75

Dr. Smith's ECG Blog

MAY 20, 2024

The Queen of Hearts disagrees, diagnosing OMI with high confidence: Case Continued: The EKG was not immediately recognized by the emergency provider, who ordered a CT scan to rule out aortic dissection at 1419. If it is angina, lowering the BP with IV Nitroglycerine may completely alleviate the pain and the (unseen) ECG ischemia.

Chest Pain 126

Chest Pain Blood Pressure Ischemia STEMI 126

EMS 12-Lead

JULY 24, 2023

Category 1 : Sudden narrowing of a coronary artery due to ACS (plaque rupture with thrombosis and/or downstream showering of platelet-fibrin aggregates. It’s judicious, then, to arrange for coronary angiogram. Supply-demand mismatch (non-occlusive coronary disease, or exacerbation of preexisting flow insufficiency) a.

Angina 52

Angina Ischemia Coronary Angiogram Stenosis 52

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

Look at the aortic outflow tract. The diagnostic coronary angiogram identified only minimal coronary artery disease, but there was a severely calcified, ‘immobile’ aortic valve. Aortic angiogram did not reveal aortic dissection. What do you see? Answer below in the still shot.

Ischemia 40

Ischemia Cardiogenic Shock Aortic Stenosis 40

BoardVitals - Cardiovascular

MAY 1, 2017

While the first one may radiate to the axilla and base, but usually not into the neck, it does reflect both aortic outflow obstruction and mitral regurgitation in patients with a large gradient. On the other hand, the murmur in valvular aortic stenosis does not change substantially or decreases slightly following the Valsalva maneuver.

Cardiomyopathy 52

Cardiomyopathy Sudden Cardiac Death Bicuspid/Mitral Electrocardiogram 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

Hgb 11g/dL (110g/L) and leukocytosis, and a mildly elevated troponin (36 ng/L, with normal 1mm STE in aVR due to ACS will require coronary artery bypass surgery for revascularization, the infarct artery is often not the LM, but rather the LAD or severe 3-vessel disease. 2 cases of Aortic Stenosis: Diffuse Subendocardial Ischemia on the ECG.

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52