Dr. Smith's ECG Blog

SEPTEMBER 9, 2024

The patient was thought to have low likelihood of ACS, and cardiology recommended repeat troponin, urine drug testing, and echocardiogram. Bedside echocardiogram showed hypokinesis of the mid to distal anterior wall and apex. Smith comment : a very high proportion of MINOCA are ruptured plaque with lysed thrombus.

Plaque 67

Plaque Stents Stent Chest Pain 67

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

Here is the cath report: Echocardiogram: There is severe hypokinesis of entire LV apex and apical segment of all the walls. To prove there is no plaque rupture, you need to do intravascular ultrasound (IVUS). An angiogram is a "lumenogram;" most plaque is EXTRALUMINAL!! ng/mL by 4th generation and older assays.)

Plaque 52

Plaque Chest Pain Thrombosis Stenosis 52

Dr. Smith's ECG Blog

JANUARY 15, 2024

ECG 2 Especially in the context of the first ECG, readers of this blog will readily appreciate the ST elevations and hyperacute T waves in II, III, aVF, V6, and to a lesser extent V5. As an aside, the LCx OMI is a type 2 event, since it is due to supply-demand mismatch from thrombus, and not due to atherosclerotic plaque rupture or erosion).

Chest Pain 64

Chest Pain Blog Arrhythmia Critical Care 64

Dr. Sanjay Gupta

DECEMBER 19, 2022

With this test, an echocardiogram is done at rest to study the pumping ability of the heart. With time, fat and cholesterol can get trapped in the areas of wear and tear and cause plaque formation. The plaques can damage us in 2 ways.

Heart Rhythm 40

Heart Rhythm Plaque Heart attacks Heart Attack 40

Dr. Smith's ECG Blog

OCTOBER 24, 2019

Troponins, echocardiogram An echocardiogram showed inferobasilar hypokinesis, further supporting a diagnosis of regional ischemia , likely of the area supplied by the RCA. Here’s the angiogram of the RCA : No thrombus or plaque rupture in the RCA (or any coronary artery) was found. The initial troponin I was elevated at 0.75

Chest Pain 52

Chest Pain SCAD STEMI Cardiogenic Shock 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

See this case: what do you think the echocardiogram shows in this case? We’ve presented many variations on this theme on Dr. Smith’s Blog — with today’s case being distinguished by its discovery on abdominal exam ! Widespread ST-depression with reciprocal aVR ST-elevation can be cause by: Heart rate related: tachyarrhythmia (e.g.,

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52

Dr. Sanjay Gupta

MARCH 6, 2022

So today i wanted to talk to you about what each heart test tells us about these different aspects of heart disease Tests that tell you about the heart as a pump The most commonly used test to assess the heart as a pump is an echocardiogram. Overall though a normal cardiac MRI is even more reassuring than a normal echocardiogram.

Heart attacks 52

Heart attacks Heart Attack Heart Rhythm Exercise 52

Dr. Smith's ECG Blog

MARCH 28, 2017

She was treated medically for NonSTEMI, pending next day cath, which showed ulcerated plaque and a 60% thrombotic stenosis in the LAD distal to the first diagonal. A formal contrast echo was done at this point : Normal estimated left ventricular ejection fraction, 65%. Regional wall motion abnormality-distal septum and apex. It was stented.

STEMI 40

STEMI Risk Factors Bicuspid/Mitral Ultrasound 40

Dr. Smith's ECG Blog

APRIL 15, 2020

Angiogram: Severe coronary artery calcification Moderate to severe distal small vessel disease mainly seen in RPL1, 2 Otherwise, Mild plaque, no angiographically significant obstructive coronary artery disease. Echocardiogram: Estimated left ventricular ejection fraction, lower limits of normal; 45-50%.

Tachycardia 52

Tachycardia Nursing Heart Disease Dysrhythmia 52

Dr. Smith's ECG Blog

JULY 31, 2018

These are reperfusion T-waves (the same thing as Wellens' waves) Echocardiogram Regional wall motion abnormality-distal septum and apex. Regional wall motion abnormality-distal inferior wall. ECG recorded at time 38 hours: A further evolutionary stage of T-wave inversion.

SCAD 52

SCAD Chest Pain Myocardial Infarction Ischemia 52

Dr. Smith's ECG Blog

JANUARY 21, 2025

In this study of consecutive patients with LBBB who were hospitalized and had an echocardiogram, a QRS duration less than 170 ms (n = 262), vs. greater than 170 ms (n = 38), was associated with a significantly better ejection fraction (36% vs. 24%). So indeed the QRS is approximately 200 ms. Comment: What is the normal QRS duration in LBBB?

Chest Pain 62

Chest Pain STEMI Tachycardia Myocardial Infarction 62

Dr. Smith's ECG Blog

FEBRUARY 6, 2025

The intricacies of the different classes of antiarrhythmics and their mechanism of action extend beyond the scope of this blog. There were no plaques or stenoses. I list below links to other cases of idiopathic VT from Dr Smith's ECG blog. It is reasonable to perform an echocardiogram to evaluate LV function.

Tachycardia 72

Tachycardia Arrhythmia Atrial Flutter Ablation 72