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A 70-something female with no previous cardiac history presented with acute chestpain. She awoke from sleep last night around 4:45 AM (3 hours prior to arrival) with pain that originated in her mid back. She stated the pain was achy/crampy. Over the course of the next hour, this pain turned into a pressure in her chest.
CT coronaryangiograms are increasing in popularity as a non-invasive screening test for detecting blocks in coronary arteries. Coronary arteries are blood vessels supplying oxygenated blood to the heart. Angiograms are images of blood vessels, usually obtained by injecting medications for contrast from body structures.
A 63 year old man with a history of hypertension, hyperlipidemia, prediabetes, and a family history of CAD developed chestpain, shortness of breath, and diaphoresis after consuming a large meal at noon. He called EMS, who arrived on scene about two hours after the onset of pain to find him hypertensive at 220 systolic.
A 34 yo woman with a history of HTN, h/o SVT s/p ablation 2006, and 5 months post-partum presented with intermittent central chestpain and SOB. She had one episode of pain the previous night and two additional episodes early on morning the morning she presented. Deep breaths are painful and symptoms come and go.
But the symptoms returned with similar pattern – provoked by exertion, and alleviated with rest; except that on each occasion the chestpain was a little more intense, and the needed recovery period was longer in duration. It’s judicious, then, to arrange for coronaryangiogram. CoronaryAngiogram 1.
The best course is to wait until the anatomy is defined by angio, then if proceeding to PCI, add Cangrelor (an IV P2Y12 inhibitor) I sent the ECG and clinical information of a 90-year old with chestpain to Dr. McLaren. All electrocardiograms (ECGs) and coronaryangiograms were blindly analyzed by experienced cardiologists.
Subscribe now Cardiac CT There are two types of cardiac CT: CT Coronary Artery Calcium (CAC) Scan CT CoronaryAngiogram (CTCA). The CAC scan looks for deposits of calcium in the areas of the coronary arteries as a proxy marker for plaque. It’s not a good test for assessing for plaque in the arteries.
A CTCA provides much more anatomical detail and can identify advanced plaque often missed by CT Coronary Artery Calcium Score scans alone. CT Coronary Artery Calcium Score Scan CT Coronary Artery Calcium Score CT CoronaryAngiogram As you can see from the above images, the CTCA provides far more anatomical detail.
Patients with coronary artery diseaseplaque buildup inside the arteries that leads to chestpain, shortness of breath, and heart attackoften undergo PCI, a non-surgical procedure in which interventional cardiologists use a catheter to place stents in the blocked coronary arteries to restore blood flow.
No prior exertional complaints of chestpain, dizziness, lightheadedness, or undue shortness of breath. He denied headache or neck pain associated with exertion. I sent this ECG to Dr. Smith, with the only information that it is a 17 year old with chestpain. 24 yo woman with chestpain: Is this STEMI?
Case 1: 20-something woman with chestpain Case 2: 50-something man with chestpain Case 1 A 20-something yo woman presented in the middle of the night with severe crushing chestpain. Angiogram Door to balloon time was 120 minutes (much too long) because of time taken for a CT. Denies SOB.
In these patients there is no plaque triggered ACS. we can witness menacingly deep resting ST depression with absolutely no thrombotic process going on in the coronary. I don’t understand how the curve of non-cardiac chestpain trespasses in the middle of a Troponin race (False positives?
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