Heart BMJ

FEBRUARY 12, 2024

Clinical introduction A patient in their 30s had been diagnosed with peripartum cardiomyopathy, pulmonary oedema, with severe left ventricular dysfunction at the seventh month of gestation in the third pregnancy in their late 20s. The coronary angiogram was normal. The renal and carotid Doppler tests were normal.

Coronary Angiogram 75

Coronary Angiogram Aortic valve Echocardiogram Aortic 75

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

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. Smith comment 2: I frequently see failure to control BP in patients with acute chest pain or acute heart failure.

Chest Pain 126

Chest Pain Blood Pressure Ischemia STEMI 126

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

DECEMBER 22, 2022

On his physical examination, cardiac and pulmonary auscultation was completely normal. As his pain was very severe, emergency physicians concerned of aortic dissection and ordered a thoracic CT scan. Bi-phasic scan showed no dissection or pulmonary embolism. He has 40 packs-year of smoking history.

STEMI 52

STEMI Chest Pain Myocardial Infarction Electrocardiogram 52

Dr. Smith's ECG Blog

JANUARY 9, 2023

CT angiogram chest: no aortic dissection or pulmonary embolism. Serial chest xrays: progressive bilateral pulmonary edema. Only after her troponin peaked at 500,000 ng/L did she get her angiogram, which showed a 100% left main occlusion due to ruptured plaque. No further troponins were measured.

Chest Pain 52

Chest Pain Aneurysm STEMI Thrombosis 52