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. We know that most type 1 acute MI due to plaque rupture and thrombosis occurs in lesions that are less than 50% (see Libby reference).
Ken Grauer, MD
FEBRUARY 3, 2024
Non-obstructive coronary disease at the time cardiac cath is done does not necessarily imply there was no plaque rupture with thrombus. These plaques will often not be recognized as "culprits" — because no fissuring or ulceration is seen. Longterm prognosis of patients with MINOCA clearly depends on the underlying etiology.
Dr. Smith's ECG Blog
DECEMBER 19, 2023
The commonest causes of MINOCA include: atherosclerotic causes such as plaque rupture or erosion with spontaneous thrombolysis, and non-atherosclerotic causes such as coronary vasospasm (sometimes called variant angina or Prinzmetal's angina), coronary embolism or thrombosis, possibly microvascular dysfunction. It is not rare.
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. But not all OMI is atherosclerotic in nature.
International Journal of Cardiovascular Sciences
JULY 11, 2024
Awards granted: a) Plaque for each awarded article. The corresponding recognition will entitle the honoree to a plaque. The Award will correspond to articles published in 2023. b) Registration for the next subsequent congress. c) Credit of R$ 2,000.00 for enrollment in courses at the Heart University. Except for postgraduate courses.
EMS 12-Lead
AUGUST 18, 2024
I interpreted the ECG as VT with two primary etiological possibilities: 1. Abrupt plaque ulceration of Type 1 ACS leading to VT. 2. Baseline fibrotic substrate from dilated cardiomyopathy leading to VT. From a clinical standpoint I reconciled the first possibility as most probable since the chest discomfort came first.
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.
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