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This EKG is diagnostic of transmural ischemia of the inferior wall. Smith: note also the terminal QRS distortion in lead III (absence of S-wave without a prominent J-wave). __ Smith comment 1 : the appropriate management at this point is to lower the bloodpressure (lower afterload, which increases myocardial oxygen demand).
A CTCA provides much more anatomical detail and can identify advanced plaque often missed by CT Coronary Artery Calcium Score scans alone. CT Coronary Artery Calcium Score Scan CT Coronary Artery Calcium Score CT CoronaryAngiogram As you can see from the above images, the CTCA provides far more anatomical detail.
The initial bloodpressure was 80/palp with a heart rate of 104, respirations 20, oxygen saturations of 94% and a finger stick blood glucose of 268. In addition, the patient received 750 mL of fluid resuscitation with transient improvement of bloodpressure.
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] Although the bloodpressure resolved, his pain, however, did not.
The bloodpressure was 170/100 in the critical care area. Cardiology wanted a CT of the aorta to rule out dissection, presumably partly due to the very high bloodpressure readings, but also because it is hard for people to believe that a 20-something woman could have acute thrombotic coronary artery.
Her bloodpressure on arrival was 153/69. The patient was started on heparin for possible NSTEMI vs demand ischemia. increasing stenosis, ischemia, volume changes, increased bloodpressure, atrial fibrillation, etc.) Smith : these ECGs do NOT show subendocardial ischemia.
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