Dr. Smith's ECG Blog

NOVEMBER 19, 2014

A male in late middle age with a history of RCA stent 8 years prior complained of chest pain. Here are three more dramatic cases that illustrate RBBB + LAFB Case 1 of cardiac arrest with unrecognized STEMI, died. EMS recorded the following ECG: What do you see?

Chest Pain 52

Chest Pain Cardiac Arrest Myocardial Infarction Angioplasty 52

Dr. Smith's ECG Blog

FEBRUARY 25, 2009

A stent was placed, and the patient had an excellent outcome with no wall motion abnormality. Were it not for this prehospital ECG and the cardiac arrest, the diagnosis may have been significantly delayed. Were it not for this prehospital ECG and the cardiac arrest, the diagnosis may have been significantly delayed.

Cardiac Arrest 52

Cardiac Arrest Chest Pain Defibrillator STEMI 52

Dr. Smith's ECG Blog

NOVEMBER 23, 2022

About an hour later, he was then found on the floor in cardiac arrest in the ED. He was taken to the cath lab where he was found to have acute total occlusion of his saphenous vein graft to his RCA, which was stented. QUESTIONS: About 1 hour after ECG #1 was done — the patient was found on the floor in the ED in cardiac arrest.

Chest Pain 52

Chest Pain Cardiac Arrest Cardiogenic Shock Heart Attack 52

Dr. Smith's ECG Blog

APRIL 8, 2016

This was stented. If cardiac arrest from hypokalemia is imminent (i.e., As I indicated above, in our cardiac arrest case, after pushing 40 mEq, the K only went up to 4.2 The mean serum potassium level was lower after resuscitation from cardiac arrest (3.6 The patient stabilized. mEq/L, from 1.9

STEMI 52

STEMI Myocardial Infarction Cardiac Arrest Arrhythmia 52

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

IntroductionThe 2015 American Heart Association Guidelines recommended mechanical thrombectomy with stent‐retriever devices. Stroke: Vascular and Interventional Neurology, Volume 3, Issue S2 , November 1, 2023.

Stroke 40

Stroke Strokes Cardiac Arrest Inpatient 40

Dr. Smith's ECG Blog

JUNE 11, 2021

But the lack of traditional Sgarbossa criteria is not reassuring enough for such high pretest probability (elderly patient with chest pain, out of hospital cardiac arrest and LBBB), and the Modified Sgarbossa Criteria confirms Occlusion MI in this case. So the RCA was stented. Any indications for cath lab activation?

Chest Pain 52

Chest Pain Cardiac Arrest Ischemia Cardiogenic Shock 52

Cardiometabolic Health Congress

JULY 17, 2024

February 2024 FDA Approvals: Innovations in Cardiovascular Interventions XACT Carotid Stent System (Approved: 02/07/2024) This approval expands the indications to be used during a Transcarotid Artery Revascularization (TCAR) procedure to prevent future strokes.

Tricuspid 59

Tricuspid Open-Heart Surgery Kidney Disease Pediatrics 59

Dr. Smith's ECG Blog

SEPTEMBER 16, 2015

A middle-aged male with h/o CAD and stents presented with typical chest pressure. A male in late middle age with a history of RCA stent 8 years prior complained of chest pain. Here are three more dramatic cases that illustrate RBBB + LAFB Case 1 of cardiac arrest with unrecognized STEMI, died.

STEMI 40

STEMI Chest Pain Cardiac Arrest Stents 40

Dr. Smith's ECG Blog

OCTOBER 8, 2023

The patient was referred immediately for cath which revealed RCA occlusion that was stented. Smith: This bizarre ECG looks like a post cardiac arrest ECG with probable acidosis or hyperkalemia in addition to OMI. There is some down sloping ST-segment and T wave inversion in lead aVL. How did the Queen of Heart AI model perform?

Ischemia 123

Ischemia Chest Pain Cardiogenic Shock Cardiac Arrest 123

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. The LAD lesion was acute and required 3 stents to restore flow. They took him almost immediately for catheterization.

Chest Pain 52

Chest Pain STEMI Cardiac Arrest Aneurysm 52

Dr. Smith's ECG Blog

SEPTEMBER 4, 2016

He had a previous MI with cardiac arrest 2 years prior. It was opened and stented. Culprit, stented) 3. A stent was placed and the patient became pain free. Down below are 3 more cases and a discussion of how to differentiate false positive isolated STE in aVL from True positive. He was clammy and looked unwell.

Ischemia 40

Ischemia Chest Pain STEMI Stenosis 40

Dr. Smith's ECG Blog

SEPTEMBER 29, 2018

It was thought to be an in stent restenosis and thrombosis from a DES placed in the same region 6 months prior. Dialysis patients had double the rate of cardiac arrest (11% vs 5%), were less likely to receive reperfusion therapy when eligible (47% vs. 75%), and had an increased odds ratio of death compared to nondialysis patients 1.5 (95%

Chest Pain 52

Chest Pain Myocardial Infarction Cardiac Arrest Ischemia 52

Dr. Smith's ECG Blog

OCTOBER 3, 2017

The patient was taken back to the cath lab, where 100% proximal in-stent rethrombosis was found and treated. This is diagnostic of re-occlusion. This ECG cannot be present 7 days after a single persistent acute occlusion. Repeat ECG after PCI: LAD occlusion resolving.

Chest Pain 52

Chest Pain STEMI Defibrillator Blog 52

Dr. Smith's ECG Blog

FEBRUARY 2, 2025

Smith comment: The patient was lucky to have a cardiac arrest. By undergoing an arrest, providers became aware of his OMI which had not been noticed on his diagnostic ECG, and he thus has a chance at some myocardial salvage. Total proximal LAD occlusion was found and stented at angiography soon after the ECG above.

Cardiac Arrest 86

Cardiac Arrest STEMI Blog Ischemia 86

Dr. Smith's ECG Blog

JANUARY 11, 2025

He had undergone stenting of the LAD several weeks ago (unclear whether elective for stable symptoms, or in response to acute coronary syndrome). Plus recommendations from a 5-member panel on cardiac arrest. Written by Pendell Meyers An adult man presented with acute chest pain. He appeared critically ill. That ( as per Dr.

Cardiogenic Shock 137

Cardiogenic Shock Chest Pain Tachycardia Cardiac Arrest 137