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Abstract 4140066: In ACS patients within 4 hours of pain to balloon time, the impact of no-reflow after PCI and ultrasound attenuation as detected by intravascular ultrasound on the incidence of no-reflow.

Circulation

A pathological classification of no-reflow was proposed: structural no-reflow—microvessels within the necrotic myocardium exhibit loss of capillary integrity (it is usually irreversible)—and functional no reflow—patency of microvasculature is compromised due to distal embolization, spasm, ischemic injury, reperfusion injury.

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American College of Cardiology ACC.24 Late-breaking Science and Guidelines Session Summary

DAIC

ET Murphy Ballroom 4 Comparison of an "Inclisiran First" Strategy with Usual Care in Patients With Atherosclerotic Cardiovascular Disease: Results From the VICTORION-INITIATE Randomized Trial Targeting Weight Loss to Personalize the Prevention of Type 2 Diabetes Once-weekly Semaglutide in Patients with Heart Failure With Preserved Ejection Fraction, (..)

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A 60-something with Syncope, LVH, and convex ST Elevation

Dr. Smith's ECG Blog

My opinion was that it was not a cath lab case, but I did suggest they do a bedside ultrasound to look for an anterior wall motion abnormality. The RV was small and IVC empty, making pulmonary embolism extremely unlikely. The RV was small and IVC empty, making pulmonary embolism extremely unlikely.

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Concerning EKG with a Non-obstructive angiogram. What happened?

Dr. Smith's ECG Blog

EMS obtained the following vital signs: pulse 50, respiratory rate 16, blood pressure 96/49. Two thirds of MINOCA cases are due to atherosclerotic causes One way to prove the diagnosis in this case would have been with intravascular imaging such as optical coherence tomography (OCT) or intravascular ultrasound (IVUS).

Plaque 127
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Abstract 4140751: “A silent death: Right heart clot in transit” Acute sub-massive pulmonary embolism

Circulation

He was requiring supplemental oxygen and an initial bedside cardiac ultrasound was unremarkable. Despite his large clot burden, there was absence of obstructive shock.Transthoracic Echocardiogram and bilateral duplex venous ultrasound were obtained to evaluate for right heart strain and clot burden. Cardiology was consulted.

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Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.

Dr. Smith's ECG Blog

Check : [vitals, SOB, Chest Pain, Ultrasound] If the patient has Abdominal Pain, Chest Pain, Dyspnea or Hypoxemia, Headache, Hypotension , then these should be considered the primary chief complaint (not syncope). Any ED systolic blood pressure less than 90 or greater than 180 mm Hg (+1) 4. orthostatic vitals b.