Dr. Smith's ECG Blog

DECEMBER 7, 2023

The final diagnosis was spontaneous coronary artery dissection (SCAD) starting in the mid LAD and continuing distally where it wraps around the apex. SCAD wasn't on my differential per se , but in retrospect it should have been. Most patients presenting with SCAD report a preceding emotional or physical stressor.

SCAD 125

SCAD Ischemia Coronary Artery Disease Cardiomyopathy 125

Dr. Smith's ECG Blog

OCTOBER 24, 2019

Here’s the angiogram of the RCA : No thrombus or plaque rupture in the RCA (or any coronary artery) was found. This MI wasn’t caused by a ruptured plaque of CAD - it was a coronary artery dissection of the RCA. In the absence of these factors it is termed spontaneous coronary artery dissection ( SCAD ). A study by Hassan et al.

Chest Pain 52

Chest Pain SCAD STEMI Cardiogenic Shock 52

Dr. Smith's ECG Blog

APRIL 8, 2022

The ECG is diagnostic for acute transmural infarction of the anterior and lateral walls, with LAD OMI being the most likely cause (which has various potential etiologies for the actual cause of the acute coronary artery occlusion, the most common of which is of course type 1 ACS, plaque rupture with thrombotic occlusion). Is there STEMI?

Chest Pain 52

Chest Pain SCAD STEMI Blog 52

Dr. Smith's ECG Blog

MAY 19, 2020

If the arrest was caused by acute MI due to plaque rupture, then the diagnosis is MINOCA. Here is my comment on MINOCA: "Non-obstructive coronary disease" does not necessarily imply "no plaque rupture with thrombus." They often cannot even be recognized as culprits, as fissured or ulcerated plaque. FFR can be useful.

Defibrillator 52

Defibrillator Circulation Plaque Cardiac Arrest 52

Dr. Smith's ECG Blog

JULY 31, 2018

What is Spontaneous Coronary Artery Dissection (SCAD)? I asked Angie Lobo ( [link] ), a third year intermal medicine resident at Abbott Northwestern Hospital (and Minneapolis Heart Institute) and an aspiring cardiologist, to write a couple paragraphs on SCAD. There are no randomized controlled trials for treatment strategies in SCAD.

SCAD 52

SCAD Chest Pain Myocardial Infarction Ischemia 52

Dr. Smith's ECG Blog

DECEMBER 16, 2024

This was ruptured plaque with thrombus. It was not SCAD (coronary dissection) Highest troponin I was 37,000 ng/L, but it was not measured to peak. We have often made the point in Dr. Smith's ECG Blog that in general it is not common to see tachycardia with an uncomplicated MI.

Chest Pain 105

Chest Pain Aortic STEMI Ultrasound 105