DAIC

FEBRUARY 29, 2024

ET Main Tent (Hall B1) This session offers more insights from key clinical trials presented at ACC.24 24 and find out what it all means for your patients.

Aortic valve 103

Aortic valve Myocardial Infarction Aortic Blood Pressure 103

Dr. Smith's ECG Blog

JANUARY 9, 2024

Are you confident there is no ischemia? Primary VT , and the VT with tachycardia is causing ischemia with chest discomfort (supply-demand mismatch/type 2 MI)? Ischemia from ACS causing the chest discomfort, with VT another consequence (or coincidence)? Do you agree with this strategy? How can you better assess the ST segments?

Tachycardia 119

Tachycardia Electrophysiology Atrial Flutter Ischemia 119

Dr. Smith's ECG Blog

DECEMBER 7, 2023

This proves effective treatment of the recurrent ischemia. The patient had no further symptoms of ischemia. EKG 3 is diagnostic for developing re-occlusion, and EKG 4 proves that the nitrates relieved the ischemia. = This proves effective treatment of the recurrent ischemia." Here was her final EKG prior to discharge.

SCAD 124

SCAD Ischemia Coronary Artery Disease Cardiomyopathy 124

Dr. Smith's ECG Blog

APRIL 24, 2020

Contrary to what Ken stated, the ST vector remains mostly posterior __ What about subendocardial ischemia? Subendocardial ischemia results in ST depression, but unfortunately, and rather mysteriously, it does not localize to the ischemic wall. Similarly, STD in aVL is usually reciprocal to inferior ST elevation, not "lateral ischemia."

Ischemia 52

Ischemia Chest Pain Stenosis STEMI 52

Hypertension Journal

JANUARY 4, 2024

Vascular inflammation underlies the development of hypertension, and the mechanisms by which it increases blood pressure remain the topic of intense investigation. Hypertension, Ahead of Print. These pathways share a dependence upon redox signaling, and excessive activation promotes oxidative stress that promotes vascular aging.

Blood Pressure 45

Blood Pressure Hypertension Atherosclerosis Ischemia 45

Stroke Journal

FEBRUARY 1, 2024

Though this association may be related to impaired cerebral oxygen delivery, it is unclear whether these changes relate to cerebral ischemia. Background:We have previously identified that hemoglobin decrements and new-onset anemia during an intracerebral hemorrhage (ICH) hospitalization is frequent, rapid, and associates with poor outcome.

Hemorrhage 40

Hemorrhage Blood Pressure Ischemia Hospital 40

Dr. Smith's ECG Blog

OCTOBER 26, 2010

He presented to the Emergency Department with a blood pressure of 111/66 and a pulse of 117. One very useful adjunct is ultrasound: Echo of his heart can distinguish aneurysm from acute MI by presence of diastolic dyskinesis, but it cannot distinguish demand ischemia from ACS. He had this ECG recorded.

STEMI 52

STEMI Cardiogenic Shock Tachycardia Aneurysm 52

Stroke Journal

JANUARY 30, 2025

Introduction:INTEREACT 4 demonstrated lowering blood pressure in the prehospital setting improves outcomes for patients with intracerebral hemorrhage (ICH) but worsens outcomes for acute cerebral ischemia (ACI). Stroke, Volume 56, Issue Suppl_1 , Page AWP142-AWP142, February 1, 2025.

Technology 40

Technology Hemorrhage Blood Pressure Ischemia 40

Stroke Journal

JANUARY 30, 2025

Introduction:Oxidative stress plays an important role in both early brain injury and delayed cerebral ischemia after subarachnoid hemorrhage (SAH). There were no differences in blood pressure or body weight between the two groups. Stroke, Volume 56, Issue Suppl_1 , Page AWP368-AWP368, February 1, 2025. P<0.05, Fig.

Hemorrhage 40

Hemorrhage Outcomes Blood Pressure Ischemia 40

Dr. Smith's ECG Blog

DECEMBER 6, 2010

Blood pressure was 150/80. He had no previous history of CAD, and presented with very typical waxing and waning chest pain, much worse with exertion but also present at rest and on presentation, though his pain was minimal at the time of the ECG. This is all suggestive of posterior STEMI, but not definitely diagnostic.

STEMI 52

STEMI Chest Pain Ultrasound Blood Pressure 52

Dr. Smith's ECG Blog

APRIL 26, 2017

Acute PE can also result in right precordial ST elevation due to RV stress and ischemia ) 90 minutes later, I was shown this followup ECG without any knowledge of the ultrasound results: There is significantly less ST elevation, and the ST segment is now concave. The RV was small and IVC empty, making pulmonary embolism extremely unlikely.

Chest Pain 52

Chest Pain STEMI Ultrasound Pulmonary 52

Dr. Smith's ECG Blog

NOVEMBER 28, 2022

Pericardial tamponade is also associated with pulsus paradoxus which is an abnormally large drop in systolic blood pressure greater than 10 mmHg during inspiration. This may be in the strength of the pulse ( or the blood pressure recorded ) — or it may be in one or more waveforms in the ECG recording.

Tachycardia 40

Tachycardia Pericarditis Ultrasound Blood Pressure 40

Dr. Smith's ECG Blog

FEBRUARY 6, 2023

The ECG was incorrectly interpreted as no signs of ischemia. He is placed on heparin drip, he will have IV beta-blocker and oral beta blocker for heart rate control and blood pressure management. A prior ECG was available: This ECG is normal, and thus confirms the concerns explained above.

Chest Pain 52

Chest Pain Physiology Blog Stents 52

Dr. Smith's ECG Blog

SEPTEMBER 7, 2020

Blood pressure was normal (109/83). NOTE #3: In the context of a long QTc or ischemia — the finding of ST segment and/or T wave alternans may predict the occurrence of malignant ventricular arrhythmias. A 30-something was in the ED for some minor trauma when he was noted to have a fast heart rate. but only when asked.

Tachycardia 52

Tachycardia Heart Disease Dysrhythmia Ablation 52

Dr. Smith's ECG Blog

JULY 3, 2020

Either could be a result of myocardial contusion There is some minimal ST depression -- this could represent ischemia What else is there that could use therapy immediately? Or, much less likely, it could be a very accelerated escape rhythm from the posterior fascicle. There is a very long ST segment resulting in a very long QT. mEq/L and 3.8

Hemorrhage 52

Hemorrhage Critical Care Blood Pressure Laboratory 52

Dr. Smith's ECG Blog

AUGUST 14, 2023

The flutter waves can conceal or mimic ischemic repolarization findings, but here I don't see any obvious findings of OMI or subendocardial ischemia. 2) Norepinephine to support Blood Pressure. The rhythm is 2:1 atrial flutter. If this were RBBB, it would need to be incomplete, as the QRS duration is less than 120 ms.

Chest Pain 52

Chest Pain Pulmonary Sickle Cell Disease Atrial Flutter 52

MIBHS

OCTOBER 31, 2024

High Blood Pressure (Hypertension) Persistent high blood pressure forces the heart to work harder to pump blood. Coronary Artery Disease (CAD) CAD, which involves the narrowing or blockage of coronary arteries due to plaque buildup, can reduce blood flow to the heart. Anticoagulants to prevent blood clots.

Blood Pressure 52

Blood Pressure Blood Clot Heart Valves Heart Rhythm 52

Dr. Smith's ECG Blog

OCTOBER 20, 2024

The first task when assessing a wide complex QRS for ischemia is to identify the end of the QRS. The ST segment changes are compatible with severe subendocardial ischemia which can be caused by type I MI from ACS or potentially from type II MI (non-obstructive coronary artery disease with supply/demand mismatch). What do you think?

Cardiogenic Shock 128

Cardiogenic Shock Ischemia Chest Pain Cardiac Arrest 128

Journal of the American Heart Association

FEBRUARY 29, 2024

BackgroundDelayed cerebral ischemia represents a significant contributor to death and disability following aneurysmal subarachnoid hemorrhage. Journal of the American Heart Association, Ahead of Print. Our analysis included 102 eligible studies. Vasospastic events were mainly assessed through microscopy of large cerebral arteries.

Ischemia 40

Ischemia Hemorrhage Blood Pressure Aneurysm 40

DAIC

MAY 16, 2024

Risk factors for PAD include smoking; having Type 1 or Type 2 diabetes, high blood pressure, high cholesterol, chronic kidney disease, atherosclerosis in other parts of the body (such as coronary artery disease); and being age 75 years or older. and Global Data From the American Heart Association.

Peripheral Arterial Disease 105

Peripheral Arterial Disease Exercise Ischemia Quality of Life 105

Stroke Journal

FEBRUARY 1, 2024

The relationship of cSS with DWI lesion presence as the outcome was assessed with logistic regression adjusted for ICH score, blood pressure change within 24 hours, and small vessel disease markers (CMB and white matter hyperintensity). DWI hyperintensities were identified if >10mm from the hematoma with decreased ADC signal.

Hemorrhage 40

Hemorrhage Ischemia Blood Pressure Stroke 40

EMS 12-Lead

APRIL 21, 2022

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 blood pressure resolved, his pain, however, did not.

Ischemia 52

Ischemia Myocardial Infarction Blog Coronary Angiogram 52

DAIC

JUNE 13, 2024

This issue may: prevent the balloon from fully inflating, cause blood to back up in the tubing, allow helium to leak, and lead to catheter damage or insertion difficulty during use. Teleflex/Arrow International reports 322 complaints. A total of 31 injuries and 3 deaths have been reported potentially related to this issue.

Aortic 115

Aortic Blood Pressure Ischemia Heart Failure 115

Stroke Journal

FEBRUARY 1, 2024

Due to conflicting prior studies, it is uncertain if the degree of systolic blood pressure reduction increases the risk. Patients with severe, chronic hypertension may be more vulnerable to the development of ischemia after ICH due to altered cerebral autoregulatory limits. and LVH was seen in 23.5%.

Hemorrhage 40

Hemorrhage Blood Pressure Hypertension Biomarkers 40

Dr. Smith's ECG Blog

MAY 3, 2024

When I was shown this ECG, I said it looks like such widespread ischemia that is might be a left main occlusion, or LM ischemia plus circumflex occlusion (high lateral and posterior OMI). There is STE in aVR. Thus, there is high lateral OMI with diffuse ST depression. Moreover, left main occlusion often presents near death.

Cardiogenic Shock 127

Cardiogenic Shock Cardiac Arrest Hospital Ischemia 127

Dr. Smith's ECG Blog

JULY 21, 2024

Immediately after contrast injection into the LMCA, the patient had circulatory collapse, with a precipitous drop in blood pressure. An Impella device was placed to maintain cardiac output and perfusion pressures. There is no definite evidence of acute ischemia. (ie, Epinephrine infusion was begun.

Arrhythmia 131

Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 131

Cardiometabolic Health Congress

MAY 10, 2024

In MSIMI (Mental Stress-induced Myocardial Ischemia) studies , mental stress activities like public speaking were evaluated for their impact on ischemia, measured via myocardial SPECT and vascular function (microvascular function, endothelial function).

Coronary Artery Disease 59

Coronary Artery Disease Obesity Chest Pain Ischemia 59

Dr. Smith's ECG Blog

OCTOBER 20, 2013

This ECG is diagnostic of diffuse subendocardial ischemia. The combination of sudden increased intracranial pressure with loss of spontaneous circulation results in near total loss of cerebral perfusion. The blood pressure produced by chest compressions is inadequate to perfuse the brain when ICP is high. Bart BA.

Cardiac Arrest 52

Cardiac Arrest STEMI Hemorrhage Hospital 52

DAIC

APRIL 8, 2024

However, the results also showed significantly higher rates of complications among patients who received the heart pump, including bleeding, limb ischemia, renal replacement therapy and sepsis. “It It doesn’t come without a cost—we see significantly more serious complications in the Impella treated patients,” Møller said.

Heart Attack 52

Heart Attack Heart attacks Cardiogenic Shock Catheterization Laboratory 52

Dr. Smith's ECG Blog

OCTOBER 7, 2019

RCA ischemia often results in sinus bradycardia from vagal reflex or ischemia of the sinus node. During transport, I had debated giving atropine for his bradycardia and cardiogenic shock, but was worried about making an already profoundly ischemic heart more ischemic, and chose instead to optimize preload with pressure bagging 1L NS.

Bradycardia 40

Bradycardia STEMI Cardiogenic Shock Ischemia 40

DAIC

JANUARY 23, 2024

1,12,13 While it is important to treat all known risk factors that contribute to ASCVD including high blood pressure, hyperlipidemia, diabetes, and obesity, physicians also need to recognize and treat systemic inflammation in CV disease. This in turn leads to an overall reduction in IL-6 production and CRP concentration.12

Cardiovascular Disease 111

Cardiovascular Disease Heart Attack Heart attacks Coronary Artery Disease 111

Dr. Paddy Barrett

AUGUST 1, 2023

Because the evidence suggests that when we do, patients end up with better blood pressure, cholesterol control and are more likely to engage in healthier behaviours. 5 ISCHEMIA Research Group. Historically, I used to describe the report and then draw a diagram, but I show patients their own scan results more and more.

Coronary Angiogram 52

Coronary Angiogram Plaque Coronary Artery Disease Chest Pain 52

EMS 12-Lead

APRIL 28, 2022

The EMS narrative reports that her blood pressure and oxygenation improved modestly with rhythm stability for transport duration. In most cases, rather, the culprit is gross ischemia due to myocardial infarction, cardiomyopathy, or advanced coronary artery disease. Unfortunately, a post-conversion 12 Lead was not acquired.

Tachycardia 52

Tachycardia AFIB Arrhythmia Coronary Artery Bypass Graft 52

Dr. Smith's ECG Blog

MAY 5, 2022

On arrival in the ED, he was hypotensive with a systolic blood pressure in the 70s. These include ( among others ) — acute febrile illness — variations in autonomic tone — hypothermia — ischemia/infarction/cardiac arrest — and Hyperkalemia. Fluid resuscitation was initiated. Here is the initial ED ECG: What do you think?

Chest Pain 52

Chest Pain Bradycardia Cardiac Arrest STEMI 52

Dr. Smith's ECG Blog

APRIL 8, 2015

Evidence of acute ischemia (may be subtle) vii. Any ED systolic blood pressure less than 90 or greater than 180 mm Hg (+1) 4. The cost per test affecting diagnosis or management was highest for electroencephalography ($32,973), CT ($24,881), and cardiac enzymes ($22,397) and lowest for postural blood pressure ($17-$20).

Arrhythmia 52

Arrhythmia Outcomes Chest Pain Risk Factors 52

Dr. Smith's ECG Blog

APRIL 6, 2025

They were unable to obtain a blood pressure. His heart rate was in the low 20s and we were also unable to obtain a blood pressure. He was given 50 mcg epinephrine with good response in both heart rate and blood pressure. There is Transmural ischemia of Occlusion MI. His temperature was 32.8

Blood Pressure 94

Blood Pressure Cardiogenic Shock Ischemia Cardiac Arrest 94

Frontiers in Cardiovascular Medicine

JANUARY 8, 2025

BackgroundPainful left bundle branch block (LBBB) syndrome is an uncommon disease that is defined as intermittent episodes of angina associated with simultaneous LBBB changes on an electrocardiogram (ECG) with the absence of flow-limiting coronary artery disease or ischemia on functional testing.

Chest Pain 52

Chest Pain Angina Coronary Artery Disease Blood Pressure 52