Cardiomyopathy, Ischemia and Plaque - Cardiovascular Update

Elder Male with Syncope

EMS 12-Lead

APRIL 9, 2024

Many of the changes seen are reminiscent of LVH with “strain,” and downstream Echo may very well corroborate such a suspicion, but since the ECG isn’t the best tool for definitively establishing the presence of LVH, we must favor a subendocardial ischemia pattern, instead. Type I ischemia. Type II ischemia.

Ischemia

Ischemia Stenosis Chest Pain Coronary Artery Disease

What does the angiogram show? The Echo? The CT coronary angiogram? How do you explain this?

Dr. Smith's ECG Blog

NOVEMBER 15, 2023

Angiogram No obstructive epicardial coronary artery disease Cannot exclude non-ACS causes of troponin elevation including coronary vasospasm, stress cardiomyopathy, microvascular disease, etc. This suggests further severe ischemia. hours T-wave are getting larger again The patient went for an angiogram at about 7 hours after arrival.

Coronary Angiogram

Coronary Angiogram Plaque Thrombosis STEMI

"A patient just arrived as a transfer for NSTEMI."

Dr. Smith's ECG Blog

DECEMBER 7, 2023

Given her lack of risk factors for coronary disease, and the fact that she was a 53 year old woman with compatible history and echo findings, stress cardiomyopathy rose to the top of my differential. Of course, stress cardiomyopathy is a diagnosis of exclusion. This proves effective treatment of the recurrent ischemia.

SCAD

SCAD Ischemia Coronary Artery Disease Cardiomyopathy

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Bridging Innovation & Patient Care: The Growing Role of AI

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Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting."

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

by making it clear to everyone that this is NOT an EKG that one sees with takotsubo cardiomyopathy. Hospital Course The patient was taken emergently to the cath lab which did not reveal any significant coronary artery disease, but she was noted to have reduced EF consistent with Takotsubo cardiomyopathy. It can only be seen by IVUS.

Plaque

Plaque Chest Pain Thrombosis Stenosis

American College of Cardiology ACC.24 Late-breaking Science and Guidelines Session Summary

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. 12:15 p.m.

Aortic valve

Aortic valve Myocardial Infarction Aortic Blood Pressure

An athletic 30-something woman with acute substernal chest pressure

Dr. Smith's ECG Blog

JULY 31, 2018

Now you have ECG and troponin evidence of ischemia, AND ventricular dysrhythmia, which means this is NOT a stable ACS. It they are static, then they are not due to ischemia. This is better evidence for ischemia than any other data point. Again, cath lab was not activated. What does this troponin level mean?

SCAD

SCAD Chest Pain Myocardial Infarction Ischemia

What do heart tests tell us?

Dr. Sanjay Gupta

MARCH 6, 2022

So cardiomyopathies, valve problems, myocarditis and previous heart attacks all cause a problem with the pumping function of the heart. These are therefore not looking for coronary disease but instead ischemia heart disease. Remember functional tests tell you about ischemia and anatomical tests tell you about coronary disease.

Heart Attack

Heart Attack Heart attacks Heart Rhythm Exercise

Understanding an Enlarged Heart (Cardiomegaly): Causes, Symptoms, and Treatment

MIBHS

OCTOBER 31, 2024

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. This may result in ischemia (lack of oxygen to the heart muscle), causing parts of the heart to weaken and enlarge.

Blood Pressure

Blood Pressure Blood Clot Heart Valves Heart Rhythm

Avocados for the Heart; Cardiology's Sad State; CBD for Pulmonary Hypertension?

Heart 2023 Conference

APRIL 20, 2022

Source: JAMA Cardiology) Patients with afib who survived an intracerebral haemorrhage had a very significant risk of cerebrovascular ischemia episodes and death in the following year, according to registry data. Patients with obstructive hypertrophic cardiomyopathy who underwent surgical myectomy reported improved quality of life.

Pulmonary

Pulmonary Hypertension AFIB COVID-19

Why is ECG machine use? What diseases can EKG monitor detect?

Wellnest

DECEMBER 21, 2022

Poor blood supply Ischemia, or inadequate blood supply to the heart, is an abnormality that can be detected in an ECG test. An ECG machine is able to detect other abnormalities of the heart as well, such as hypertrophic cardiomyopathy or overly thick heart muscles. ECG tests can also show previous heart attacks.

Cardiac Arrest

Cardiac Arrest Heart Attack Heart attacks Atrial Fibrillation

Syncope and Block

EMS 12-Lead

JUNE 1, 2022

Such findings would normally suggest primary ischemia with concomitant surveillance of coronary occlusion, but these ST/T changes might very well be secondary to the Escape mechanism at hand. LBBB is typically the result of preexisting hypertrophy, ischemic heart disease, or cardiomyopathy. 5] Isnard, R. & Pousset, F.

Heart Failure

Heart Failure Myocardial Infarction Bradycardia Chest Pain

A teenager with chest pain, a troponin below the limit of detection, and "benign early repolarization"

Dr. Smith's ECG Blog

JANUARY 9, 2023

No family history of sudden cardiac death, cardiomyopathy, premature CAD, or other cardiac issues. Pattern consistent with Takotsubo's cardiomyopathy." Only after her troponin peaked at 500,000 ng/L did she get her angiogram, which showed a 100% left main occlusion due to ruptured plaque. No similar symptoms in the past.

Chest Pain

Chest Pain Aneurysm STEMI Thrombosis

Patient is informed of her husband's death: is it OMI or it stress cardiomyopathy?

Dr. Smith's ECG Blog

MARCH 8, 2025

Repeat ECG was obtained immediately, just 24 minutes after the prior ECG: Given the context, my top differential diagnosis would be stress cardiomyopathy AKA takotsubo. It is possible there is microvascular dysfunction producing residual transmural ischemia. The changes start to become apparent about 25 seconds into the video.

Cardiomyopathy

Cardiomyopathy Myocardial Infarction Defibrillator Bradycardia

Electrical instability in a healthy 50 year old. How to manage?

Dr. Smith's ECG Blog

FEBRUARY 6, 2025

Whenever I see PVCs with the morphology and axis seen in todays case I always look for signs of AC ( Arrhythmogenic Cardiomyopathy ). Arrhythmogenic cardiomyopathy often manifests with PVCs from the RV. The ECG in Figure-1 however, shows no signs of arrhythmogenic cardiomyopathy. There were no plaques or stenoses.

Tachycardia

Tachycardia Arrhythmia Ablation Atrial Flutter

Elder Male with Syncope

What does the angiogram show? The Echo? The CT coronary angiogram? How do you explain this?

"A patient just arrived as a transfer for NSTEMI."

Webinars

Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting."

American College of Cardiology ACC.24 Late-breaking Science and Guidelines Session Summary

An athletic 30-something woman with acute substernal chest pressure

What do heart tests tell us?

Understanding an Enlarged Heart (Cardiomegaly): Causes, Symptoms, and Treatment

Avocados for the Heart; Cardiology's Sad State; CBD for Pulmonary Hypertension?

Why is ECG machine use? What diseases can EKG monitor detect?

Syncope and Block

A teenager with chest pain, a troponin below the limit of detection, and "benign early repolarization"

Patient is informed of her husband's death: is it OMI or it stress cardiomyopathy?

Electrical instability in a healthy 50 year old. How to manage?

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