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This EKG is diagnostic of transmural ischemia of the inferior wall. If it is angina, lowering the BP with IV Nitroglycerine may completely alleviate the pain and the (unseen) ECG ischemia. There is an area of dense white in the middle of the circle consistent with atherosclerosis. Lead I also shows reciprocal ST depression.
Coronary heart disease is a narrowing or obstruction of the vascular cavity caused by atherosclerosis of the coronary arteries, which leads to myocardial ischemia and hypoxia. At present, percutaneous coronary intervention (PCI) is an effective treatment for coronary atherosclerotic heart disease.
It was a 60yo with a history of stents to the circumflex and right coronary arteries, who presented with 9 hours of fluctuating central chest pain. 2] Here there is no posterior ST elevation, but the anterior ST depression is also less—so it is dynamic, confirming acute ischemia. But it is still STEMI negative.
There is appreciable STE aVR with near-global STD that appropriately maximizes in Leads II and V5, and thus suggesting a circumstance of generic, diffusely populated, circumferential subendocardial ischemia versus occlusive coronary thrombus. [1] STEMI was activated and the patient went to Cath on arrival.
A CT CAC scan can only identify if there is calcified atherosclerosis, where it is and to what extent. A CT CAC scan of 0 indicates no significant amount of calcified atherosclerosis. It does not imply that there is NO advanced atherosclerosis. 5 ISCHEMIA Research Group. And it matters. Eur Heart J. N Engl J Med.
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