Dr. Smith's ECG Blog

NOVEMBER 15, 2023

Post cath ECG: Now there are hyperacute T-waves again, and recurrent ST depression in V2 This ECG would normally diagnostic of OMI until proven otherwise No further troponins were measured, but it looks like there is recurrent OMI Next day: A CT Coronary Angiogram was done (CTCA) CARDIAC MORPHOLOGY AND FUNCTION: 1. IMPRESSION: 1.

Coronary Angiogram 109

Coronary Angiogram Plaque Thrombosis STEMI 109

Dr. Smith's ECG Blog

JUNE 5, 2024

IMPRESSION: The finding of sinus bradycardia with 1st-degree AV block + marked sinus arrhythmia + the change in PR interval from beat #5-to-beat #6 — suggests a form of vagotonic block ( See My Comment in the October 9, 2020 post in Dr. Smith's ECG Blog ).

Chest Pain 121

Chest Pain Blog Cardiac Arrest Cardiomyopathy 121

Dr. Smith's ECG Blog

JULY 2, 2023

Outcome The only followup we got was that the patient is undergoing Coronary Bypass (CABG) of LAD, 2nd Obtuse Marginal, and Left Posterolateral coronaries. We don't know if he had a stress test, a CT Coronary angiogram, or they just decided to do an angiogram. Troponins negative."

Chest Pain 52

Chest Pain Angina Coronary Angiogram Blog 52

Dr. Smith's ECG Blog

MAY 16, 2023

No angiogram was performed. Other outcome information is not available. Like they would for any other acute arterial occlusion syndrome (such as suspicion of acute large vessel stroke), they take the patient across the hall and perform an immediate CT (coronary) angiogram, showing patent coronaries.

Chest Pain 52

Chest Pain Pericarditis Tachycardia STEMI 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

We investigated the incidence of an acutely occluded coronary in patients presenting with STE-aVR with multi-lead ST depression. All electrocardiograms (ECGs) and coronary angiograms were blindly analyzed by experienced cardiologists. A normal PR interval. BOTTOM Line from Today’s Case: As per Drs.

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52

Dr. Smith's ECG Blog

JANUARY 9, 2023

Smith Major Learning Point: The worst risk factor for a bad outcome in OMI is young age because cardiologists cannot believe that a young person can have an OMI. Young people can suffer acute coronary occlusion, whether by typical atherosclerotic plaque rupture, or by coronary anomalies, coronary aneurysms, dissections, spasm, etc.

Chest Pain 52

Chest Pain Aneurysm STEMI Thrombosis 52

Dr. Smith's ECG Blog

MARCH 3, 2025

Case Continued The patient was discharged from the hospital with a plan for a scheduled coronary angiogram to assess the coronary arteries and the possibility of aortic valve replacement. The vast majority of ischemia from supply demand mismatch is diffuse ST depression, with ST Elevation in aVR.

Tachycardia 73

Tachycardia Pulmonary Chest Pain Stenosis 73