Dr. Smith's ECG Blog

JULY 21, 2024

Troponin T peaked at 38,398 ng/L ( = a very large myocardial infarction, but not massive-- thanks to the pre-PCI spontaneous reperfusion, and rapid internvention!! ). There is no definite evidence of acute ischemia. (ie, Some residual ischemia in the infarct border might still be present.

Arrhythmia 131

Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 131

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

His response: “subendocardial ischemia. Smith : It should be noted that, in subendocardial ischemia, in contrast to OMI, absence of wall motion abnormality is common. With the history of Afib, CTA abdomen was ordered to r/o mesenteric ischemia vs ischemic colitis vs small bowel obstruction. Anything more on history?

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52

Dr. Smith's ECG Blog

AUGUST 19, 2023

They had had twice the rate of cardiac arrest and twice the in-hospital mortality[1] In another study of patients diagnosed with STEMI, those on dialysis experienced delayed reperfusion and double the mortality.[2] Clinical characteristics of dialysis patients with acute myocardial infarction in the United States.

Chest Pain 98

Chest Pain STEMI Myocardial Infarction Blog 98

DAIC

APRIL 8, 2024

The new trial, called DanGer Shock , is the first trial powered to examine whether the use of micro-axial flow pumps can improve survival in ST-elevation myocardial infarctions (STEMI, the most serious type of heart attack) that are complicated by cardiogenic shock. Overall, we have more complications, but we also save lives.”

Heart Attack 52

Heart Attack Heart attacks Cardiogenic Shock Catheterization Laboratory 52

Dr. Smith's ECG Blog

MAY 6, 2019

Followup ECG: No Change Absence of evolution is the best evidence against ischemia as the etiology. I was taught that the tell-tale sign of ischemia vs an electrical abnormality was in the hx, i.e. chest pain for the ischemia and potential syncope for brugada. Ischemia/infarction. It helps a little bit.

Chest Pain 52

Chest Pain STEMI Ischemia Myocardial Infarction 52

Dr. Smith's ECG Blog

SEPTEMBER 29, 2018

Normally, concavity in ST segments suggests absence of anterior ischemia (though concavity by itself is not reassuring - see this study ). Acute myocardial infarction in patients with dialysis Patients on dialysis have a well studied history of underdiagnosis and undertreatment for acute myocardial infarction.

Chest Pain 52

Chest Pain Myocardial Infarction Cardiac Arrest Ischemia 52

DAIC

JANUARY 23, 2024

3 Patients with ASCVD are at a higher risk for major adverse cardiovascular events (MACE) including heart attack or myocardial infarction (MI), stroke, and cardiovascular (CV) death.4 Efficacy and Safety of Low-Dose Colchicine after Myocardial Infarction. 4 In the U.S. 12 Colchicine, 0.5 34 Colchicine, 0.5 N Engl J Med.

Cardiovascular Disease 111

Cardiovascular Disease Heart Attack Heart attacks Coronary Artery Disease 111

Dr. Smith's ECG Blog

NOVEMBER 11, 2022

The ECG is diagnostic of LAD occlusion (or even left main occlusion possibly), with the classic pattern of RBBB and LAFB with huge concordant STE in V1-V2, I, and aVL, with reciprocal depression in most other leads (and/or a component of subendocardial ischemia pattern). Plus recommendations from a 5-member panel on cardiac arrest.

Chest Pain 52

Chest Pain Cardiogenic Shock Tachycardia Ischemia 52

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

It is apparently fortunate that she had a cardiac arrest; otherwise, her ECG would have been ignored. Then they did an MRI: Patient underwent cardiac MRI on 10/4 that showed mildly reduced BiV systolic function. Such cases are classified as MINOCA (Myocardial Infarction with Non-Obstructed Coronary Arteries).

Plaque 52

Plaque Chest Pain Thrombosis Stenosis 52

Cardiology Update

APRIL 30, 2024

The highly impactful International Study of Comparative Health Effectiveness With Medical and Invasive Approaches ( ISCHEMIA ) trial investigated the effectiveness of invasive (INV) versus conservative (CON) strategies for managing stable coronary artery disease. EuroIntervention. 2024 Mar 5:EIJ-D-24-00011.

Coronary Artery Disease 119

Coronary Artery Disease Ischemia Outcomes Cardiac Arrest 119

Journal of the American Heart Association

FEBRUARY 27, 2024

We evaluated the primary outcome (cardiovascular death, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest) and other end points, by sex, in 1168 (22.6%) women and 4011 (77.4%) men. of invasive‐assigned women revascularized versus 81.2%

Ischemia 45

Ischemia Coronary Artery Disease Myocardial Infarction Outcomes 45

Dr. Smith's ECG Blog

JANUARY 28, 2012

The patient might be having cardiac ischemia, but if he is, it is unstable angina or non-STEMI, or perhaps he has not YET pseudonormalized, so serial ECGs may be important. Differential of peri-infarct pericardial fluid The differential includes 1) pericarditis with effusion or 2) hemopericardium. These patients may survive.

Chest Pain 40

Chest Pain STEMI Pericarditis Ultrasound 40

Dr. Smith's ECG Blog

JANUARY 21, 2023

Clinical questions : Is this an occlusion myocardial infarction and does the patient need the cath lab? Occurrence of “J Waves” in 12-Lead ECG as a Marker of Acute Ischemia and Their Cellular Basis. Occurrence of "J waves" in 12-lead ECG as a marker of acute ischemia and their cellular basis. Pacing Clin Electrophysiol.

STEMI 52

STEMI Bradycardia Arrhythmia Cardiac Arrest 52