Dr. Smith's ECG Blog

OCTOBER 4, 2010

An echocardiogram confirmed aortic stenosis with a large pressure gradient. Now there is much less ST segment deviation, less elevation and less depression. The troponin returned positive, and the maximum troponin was 3.8 The next day, and angiogram showed normal coronary arteries. He awoke and did well.

Cardiac Arrest 52

Cardiac Arrest Ischemia Stenosis STEMI 52

Dr. Smith's ECG Blog

SEPTEMBER 29, 2024

Although one may have all kinds of ischemic findings as a result of cardiac arrest (rather than cause of cardiac arrest), this degree of ST elevation and HATW is all but diagnostic of acute proximal LAD occlusion. This prompted cath lab activation. On arrival to the ED, this ECG was recorded: What do you think?

Cardiac Arrest 109

Cardiac Arrest STEMI Ischemia SCAD 109

EMS 12-Lead

JULY 24, 2023

Category 2 : An increase in myocardial oxygen demand due to tachycardia, elevated ventricular afterload (BP or aortic stenosis), or increased wall stretch (admittedly this latter is more complicated) or a decrease in oxygen supply due to hypotension, anemia, hypoxia, or a combination of all of the above. Aortic Stenosis f.

Angina 52

Angina Ischemia Coronary Angiogram Stenosis 52

Dr. Smith's ECG Blog

MAY 19, 2020

I suspect this is Type 2 MI due to prolonged severe hypotension from cardiac arrest. distal stenosis or occluded small branches), and 3) nonischemic causes for myocyte injury (e.g., In non-arrest situations — escape beats and escape rhythms tend to be at least fairly regular. pulmonary embolism, sepsis, etc.),

Defibrillator 52

Defibrillator Circulation Plaque Cardiac Arrest 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. She was defibrillated and resuscitated. Smith: this ECG and clinical presentation is diagnostic of LAD Occlusion.

Plaque 52

Plaque Chest Pain Thrombosis Stenosis 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

History sounds concerning for ACS (could be critical stenosis, triple vessel), but differential also includes dissection, GI bleed, etc. 2 cases of Aortic Stenosis: Diffuse Subendocardial Ischemia on the ECG. Thirty-six patients (36%) presented with cardiac arrest, and 78% (28/36) underwent emergent angiography.

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52

Dr. Smith's ECG Blog

SEPTEMBER 4, 2016

He had a previous MI with cardiac arrest 2 years prior. LM: No significant stenosis. LAD: luminal irregularities with a 40% stenosis at the take-off of a D3. D3 has a 95% tubular ostial stenosis. LCX: Luminal irregularities, no significant stenosis. Two OM branches without significant stenosis.

Ischemia 40

Ischemia Chest Pain STEMI Stenosis 40

Dr. Smith's ECG Blog

JANUARY 4, 2021

The patient was subsequently given 5000 units of heparin, 180 mg of ticagrelor, and defib pads were placed on the patient in the event that he should have a cardiac arrest. Angiogram Culprit Lesion: 90% mid LAD stenosis with evidence of plaque rupture, TIMI III flow on angiography.

Ischemia 40

Ischemia Pulmonary STEMI Chest Pain 40

Dr. Smith's ECG Blog

APRIL 15, 2019

If a patient presents with chest pain and a normal heart rate, or with shockable cardiac arrest, then ischemic appearing ST elevation is STEMI until proven otherwise. I said I think there is a fixed stenosis in the LAD and the tachycardia and stress caused a type 2 STEMI.

Tachycardia 40

Tachycardia STEMI Chest Pain Ischemia 40

Dr. Smith's ECG Blog

JUNE 27, 2024

A patient had a cardiac arrest with ventricular fibrillation and was successfully defibrillated. This is FAR LESS than all other studies of shockable arrest. Coronary Angiography after Cardiac Arrest without ST-Segment Elevation. The proof of this is that only 5% of patients enrolled had acute coronary occlusion.

Defibrillator 112

Defibrillator Cardiac Arrest STEMI Chest Pain 112

DAIC

APRIL 6, 2024

Chugh, the Pauline and Harold Price Chair in Cardiac Electrophysiology Research at Cedars-Sinai, investigates the causes of and potential treatments for abnormal heart rhythms, including sudden cardiac arrest. Experts Available The following experts also are available for interviews throughout ACC.24: 24: Christine M.

Research 105

Research Cardiac Arrest Electrophysiology Chest Pain 105

Dr. Smith's ECG Blog

OCTOBER 20, 2024

This patient is actively dying from a left main coronary artery OMI and cardiac arrest from VT/VF or PEA is imminent! Complete LMCA occlusion is associated with clinical shock and/or cardiac arrest. Below is a still image with the red arrow indicating the subtotal LMCA stenosis.

Cardiogenic Shock 127

Cardiogenic Shock Ischemia Chest Pain Cardiac Arrest 127

Dr. Smith's ECG Blog

FEBRUARY 25, 2009

Angiography revealed a very tight LAD stenosis with some flow (confirming the reperfusion that we see on the ECG). Were it not for this prehospital ECG and the cardiac arrest, the diagnosis may have been significantly delayed. A stent was placed, and the patient had an excellent outcome with no wall motion abnormality.

Cardiac Arrest 52

Cardiac Arrest Chest Pain Defibrillator STEMI 52

Ken Grauer, MD

JUNE 6, 2023

It showed reduced LV function — significant concentric LVH — a dilated left atrium — severe aortic stenosis ( seemingly in need of prompt valve replacement ) — and at least moderate pulmonary hypertension , with resultant moderate pulmonary regurgitation. The plan was to proceed as soon as possible with aortic valve replacement.

Blog 78

Blog Pulmonary Hypertension Aortic 78

Dr. Smith's ECG Blog

JULY 21, 2024

Angiography : LMCA — 90-99% osteal stenosis. LCx — 50-69% stenosis of the 1st marginal branch; with 100% distal LCx occlusion. Cath findings shown above in Dr. Nossen's discussion confirm multi-vessel disease , including 90-99% osteal stenosis of the LMCA. The image shows the impella device in place.

Arrhythmia 130

Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 130

Dr. Smith's ECG Blog

SEPTEMBER 16, 2015

Is there likely to be fixed coronary stenosis that led to demand ischemia during pneumonia? --Was Here are three more dramatic cases that illustrate RBBB + LAFB Case 1 of cardiac arrest with unrecognized STEMI, died. 30 minutes later, this ECG was recorded: There is less high lateral ST elevation And another 3.5

STEMI 40

STEMI Chest Pain Cardiac Arrest Stent 40

Dr. Smith's ECG Blog

SEPTEMBER 20, 2018

They found an acute lesion of the LAD at the site of the prior stents, including 70% proximal LAD lesion and 95% mid-LAD stenosis with TIMI 3 flow at the time of cath. They took him almost immediately for catheterization. There was also a chronic total occlusion of the RCA. The LAD lesion was acute and required 3 stents to restore flow.

Chest Pain 52

Chest Pain STEMI Cardiac Arrest Aneurysm 52

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 men, and no ≥50% stenosis in 12.3% versus 4.5% (P<0.001).

Ischemia 45

Ischemia Coronary Artery Disease Myocardial Infarction Outcomes 45