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Revascularization Strategies in Stable Coronary Artery Disease: ISCHEMIA Trial Insights

Cardiology Update

In the ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) trial, researchers examined the risk of ischemic events in patients with stable coronary artery disease. years, with 57.1% occurring within 30 days after CABG. Original article: Redfors B et al.

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Resuscitated from ventricular fibrillation. Should the cath lab be activated?

Dr. Smith's ECG Blog

The ECG shows severe ischemia, possibly posterior OMI. But cardiac arrest is a period of near zero flow in the coronary arteries and causes SEVERE ischemia. It takes time for that ischemia to resolve. After cardiac arrest, I ALWAYS wait 15 minutes after an ECG like this and record another.

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Missed myocardial infarction with subsequent cardiac arrest

Dr. Smith's ECG Blog

Such T-waves are almost always reciprocal to ischemia in the region of aVL (although aVL looks n ormal here) , and in a patient with chest pain are nearly diagnostic of ischemia. Ischemia on the ECG can be very subtle and is easily missed. Ischemia on the ECG can be very subtle and is easily missed. Lesson : 1.

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Cardiac arrest: even after the angiogram, the diagnosis is not always clear

Dr. Smith's ECG Blog

STE limited to aVR is due to diffuse subendocardial ischemia, but what of STE in both aVR and V1? The additional ST Elevation in V1 is not usually seen with diffuse subendocardial ischemia, and suggests that something else, like STEMI from LAD occlusion, could be present. Was this: 1) ACS with ischemia and spontaneous reperfusion?

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ECG Blog #436 — Bigeminy or Alternans?

Ken Grauer, MD

He developed cardiac arrest shortly after the ECG in Figure-1 was recorded. Acute myocardial ischemia. Cardiac Sarcoidosis. Primary Cardiac Tumors and/or Cardiac Metastasis. C ASE C onclusion: As noted above — today's patient developed cardiac arrest shortly after arrival in the ED.

Blog 160
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Cardiac Arrest, acute ST elevation and depression superimposed on LVH, but NOT due to ACS

Dr. Smith's ECG Blog

There is profound LVH with anterolateral ST elevation and reciprocal ST depression in II, III, aVF, and ST depression in V5 and V6 that could all be secondary to LVH or could represent ischemia superimposed on the repolarization abnormalities of LVH: note that wherever there is ST depression, it is associated with a very high voltage R-wave.

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A man in his 60s with syncope and ST depression. What does the ECG mean?

Dr. Smith's ECG Blog

A prior ECG was available for comparison: Normal One might be tempted to interpret the ST depression as ischemia, but as Smith says, "when the QT is impossibly long, think of hypokalemia and a U-wave rather than T-wave." Polymorphic Ventricular Tachycardia Long QT Syndrome with Continuously Recurrent Polymorphic VT: Management Cardiac Arrest.