Dr. Smith's ECG Blog

NOVEMBER 15, 2023

A 70-something female with no previous cardiac history presented with acute chest pain. 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.

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Coronary Angiogram Plaque Thrombosis STEMI 109

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

This patient, who is a mid 60s female with a history of hypertension, hyperlipidemia and GERD, called 911 because of chest pain. A mid 60s woman with history of hypertension, hyperlipidemia, and GERD called 911 for chest pain. It is also NOT the clinical scenario of takotsubo (a week of intermittent chest pain).

Plaque 52

Plaque Chest Pain Thrombosis Stenosis 52

Dr. Smith's ECG Blog

OCTOBER 12, 2024

Preliminary findings documented in the cath lab were “Anterior STEMI and no significant coronary artery disease.” (!!!) Terminal QRS distortion is present in anterior myocardial infarction but absent in early repolarization. Following PCI, the patient ruled out by troponins : troponin increased to 0.08 2017.04.005.

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STEMI Document Blog Ischemia 115

Dr. Smith's ECG Blog

MAY 10, 2023

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 chest pain 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.

Coronary Angiogram 52

Coronary Angiogram Chest Pain Stenosis STEMI 52

Dr. Smith's ECG Blog

APRIL 20, 2018

female with HTN, HLD, diabetes, ESRD on dialysis is brought in by EMS with sudden onset, left -sided chest pain for the past four hours. While she was in her bed at home, she had sudden onset of left sided chest pain that radiated to her shoulder. The pain was pleuritic, without nausea or diaphoresis.

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Chest Pain Ultrasound Risk Factors STEMI 40

Dr. Smith's ECG Blog

OCTOBER 6, 2018

We knew only that the ECG belonged to a man in his 50s with chest pain and normal vitals. The patient was in his 50s with history of hypertension, diabetes, seizure disorder, and smoking, but no known coronary artery disease. He had no further pain and went to bed that night with no complaints.

Chest Pain 40

Chest Pain STEMI Myocardial Infarction Coronary Artery Disease 40

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

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 chest pain to Dr. McLaren. Incidence of an acute coronary occlusion. Incidence of an Acute Coronary Occlusion.

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52

DAIC

MAY 14, 2024

Together, the two companies will work to further the development and commercialization of Medis Quantitative Flow Ratio (Medis QFR), a non-invasive approach to the assessment of coronary physiology, as part of GE HealthCare’s interventional cardiology portfolio built around the Allia Platform.

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Coronary Artery Disease Interventional Cardiology Innovation Physiology 111

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

It was edited by Smith CASE : A 52-year-old male with a past medical history of hypertension and COPD summoned EMS with complaints of chest pain, weakness and nausea. The diagnostic coronary angiogram identified only minimal coronary artery disease, but there was a severely calcified, ‘immobile’ aortic valve.

Ischemia 40

Ischemia Cardiogenic Shock Aortic Stenosis 40

DAIC

MAY 8, 2024

1 Atherosclerosis is a systemic disease that affects multiple vascular regions and is particularly severe in PAD patients, where up to 80 percent suffer from concurrent coronary artery disease (CAD), historically linked with a mortality rate exceeding 50 percent within five years.

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Coronary Artery Disease Chest Pain Ischemia Myocardial Infarction 111

MIBHS

MARCH 31, 2025

A heart attack, or myocardial infarction, happens when an artery becomes blocked, reducing blood flow to the heart muscle. This blockage is often caused by a blood clot or the buildup of plaque in the coronary arteries, which supply the heart with oxygen-rich blood. What is a Heart Attack?

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Cardiac Arrest Heart Attack Heart attacks Chest Pain 52

Open Heart

AUGUST 3, 2024

Background Guidelines recommend the use of risk scores to select patients for further investigation after myocardial infarction has been ruled out but their utility to identify those with coronary artery disease is uncertain. –4.6)) and a TIMI risk score ≥1 (OR 12.9 (3.0–56.0)), –100%).

Coronary Artery Disease 52

Coronary Artery Disease Myocardial Infarction Chest Pain Thrombolysis 52

Dr. Paddy Barrett

JANUARY 30, 2024

The key issue when it comes to the near-term risk of a heart attack is whether you already have coronary artery disease and how much of it. MI = Myocardial Infarction/Heart Attack However, there are two very important caveats. 2023, 2 Coronary CT Angiography and 5-Year Risk of Myocardial Infarction.

Heart Disease 95

Heart Disease Heart attacks Heart Attack Plaque 95

Circulation: Cardiovascular Quality & Outcomes

FEBRUARY 3, 2025

BACKGROUND:The PRECISE (Prospective Randomized Trial of the Optimal Evaluation of Cardiac Symptoms and Revascularization) demonstrated that a precision diagnostic strategy reduced the primary composite of death, nonfatal myocardial infarction, or catheterization without obstructive coronary artery disease by 65% in patients with nonacute chest pain (..)

Chest Pain 40

Chest Pain Outcomes Coronary Artery Disease Myocardial Infarction 40

Open Heart

AUGUST 25, 2024

All the patients underwent NISI (involving myocardial perfusion imaging/stress echocardiography). The primary endpoints included cardiac death, non-fatal myocardial infarction and unplanned coronary revascularisation. Methods We prospectively included 1384 patients with LRHSs between March 2019 and March 2021.

Chest Pain 52

Chest Pain Coronary Artery Disease Myocardial Infarction Electrocardiogram 52

Open Heart

MARCH 1, 2023

Background As only a small proportion of patients with chest pain suffers from myocardial infarction (MI), safe rule-out of MI is of immense importance. Recently an ultrasensitive microphone performing diastolic heart sound analysis (CADScorSystem) for rule-out of coronary artery disease (CAD) has emerged.

Myocardial Infarction 52

Myocardial Infarction Chest Pain Coronary Artery Disease Hypertension 52

Coronary Artery Disease Journal

MAY 27, 2024

Objectives Patients presenting with suspected ST segment elevation myocardial infarction frequently have symptoms in addition to chest pain, including dyspnea, nausea or vomiting, diaphoresis, and lightheadedness or syncope. These symptoms are often regarded as supporting the diagnosis of infarction.

Chest Pain 40

Chest Pain Myocardial Infarction Stenosis Hospital 40

DAIC

APRIL 2, 2025

Stone, MD Mount Sinai Health System tim.hodson Wed, 04/02/2025 - 15:26 March 31, 2025 Using intravascular imaging (IVI) to guide stent implantation during complex stenting procedures is safer and more effective for patients with severely calcified coronary artery disease than conventional angiography, the more commonly used technique.

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Stents Stent Outcomes Coronary Angiogram 40

Circulation

NOVEMBER 11, 2024

Introduction:Over 6 million patients (pts) present to US emergency departments annually with chest pain (CP), of which the majority are found to have no serious disease. Evaluation of these pts results in substantial costs for unnecessary hospitalization and extensive testing. Length of stay (LOS) in the CPU to discharge was 10.4

Chest Pain 40

Chest Pain ACE Inhibitor Cardiac Function Coronary Artery Disease 40

BoardVitals - Cardiovascular

FEBRUARY 10, 2020

Cardiology Board Review Question A 48-year-old female with no known medical history presents with acute substernal chest pain. Patients typically present with acute chest pain, shortness of breath, or syncope. Usually, the regional wall motion abnormality extends beyond the territory perfused by a single coronary artery.

Cardiomyopathy 52

Cardiomyopathy Chest Pain Heart attacks Heart Attack 52

DAIC

JANUARY 25, 2024

mg tablets), together with Caristo Diagnostics , a leading cardiac disease diagnostics company with the novel CaRi-Heart technology to visualize and quantify coronary inflammation, announced today their collaboration to improve awareness and clinical education about the central role of inflammation in coronary artery disease.

Heart Attack 110

Heart Attack Heart attacks Technology Cardiovascular Disease 110

MIBHS

OCTOBER 15, 2024

Without oxygen, the cells would quickly die, leading to a heart attack (myocardial infarction). Removal of Deoxygenated Blood via Coronary Veins After the heart muscle cells have extracted oxygen from the blood, the deoxygenated blood needs to be carried away. Any interruption in this process can result in serious consequences.

Circulation 52

Circulation Heart attacks Heart Attack Chest Pain 52

Dr. Paddy Barrett

AUGUST 1, 2023

CT coronary angiography, in addition to a CT CAC, is arguably the best test for estimating whether someone has evidence of coronary artery disease and what that means for their near-term risk of a heart attack. This article is part 2 of a series on cardiac CT. I would say yes. For very good reason. And it matters.

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Coronary Angiogram Plaque Coronary Artery Disease Chest Pain 52

Coronary Artery Disease Journal

JULY 7, 2024

Background In myocardial infarction with nonobstructive coronary arteries (MINOCA), there are limited patient-level data on outcomes by sex and race. The primary outcome was nonfatal MI with secondary outcomes including nonfatal cerebrovascular accident (CVA), chest pain readmission, and repeat coronary angiography.

Myocardial Infarction 40

Myocardial Infarction Chest Pain Angina Outcomes 40

Dr. Anish Koka

MAY 16, 2023

Knowledge of this fundamental pillar of biology should drive how cardiologists approach men and women being evaluated for the presence of significant coronary disease. Atypical angina is classified as having any two of the three symptoms, and non-anginal pain any one of the three symptoms. versus 66.3%; P =0.004), older age (62.4±7.9

Chest Pain 52

Chest Pain Coronary Artery Disease Cancer Heart Attack 52

DAIC

OCTOBER 15, 2024

15, 2024 – Elucid has announced that four of the seven Medicare Administrative Contractors (MACs) will extend coverage for AI-enabled quantitative coronary plaque analysis, including its FDA-cleared PlaqueIQ image analysis software, beginning Nov. In the United States, one person dies every 33 seconds from cardiovascular disease.

Plaque 52

Plaque Medicare Chest Pain Coronary Artery Disease 52

Cardiometabolic Health Congress

MAY 10, 2024

In a study published by the American Heart Association, “Sex and Age Differences in the Association of Depression With Obstructive Coronary Artery Disease and Adverse Cardiovascular Events,” researchers investigated 3,237 patients (35% women) undergoing coronary angiography to evaluate for coronary artery disease (CAD).

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Coronary Artery Disease Obesity Chest Pain Ischemia 59

Dr. Smith's ECG Blog

AUGUST 9, 2019

At the bottom of the post, I have re-printed the section on aVR in my article on the ECG in ACS from the Canadian Journal of Cardiology: New Insights Into the Use of the 12-Lead Electrocardiogram for Diagnosing Acute Myocardial Infarction in the Emergency Department Case 1. Widimsky P et al. O'Gara PT, Kushner FG, Ascheim DD, et al.

Myocardial Infarction 52

Myocardial Infarction Ischemia STEMI Cardiogenic Shock 52

Dr. Smith's ECG Blog

MARCH 6, 2019

A middle-aged woman with history of hypertension presented to another hospital approximately 2 hours after onset of chest pain and shortness of breath. Mechanical Reperfusion in Patients with Acute Myocardial Infarction Presenting More than 12 Hours from Symptom Onset: A Randomized Controlled Trial. mm STE in V1 and 1.5-2.0

STEMI 52

STEMI Chest Pain Ischemia Myocardial Infarction 52

Dr. Smith's ECG Blog

JULY 21, 2024

The patient in today’s case is a previously healthy 40-something male who contacted EMS due to acute onset crushing chest pain. The pain was 10/10 in intensity radiating bilaterally to the shoulders and also to the left arm and neck. Written By Magnus Nossen — with edits by Ken Grauer and Smith. The below ECG was recorded.

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Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 131

MIBHS

DECEMBER 13, 2024

One of the most effective treatments for severe coronary artery disease, a type of cardiovascular disease, is coronary artery bypass grafting (CABG), a procedure designed to restore blood flow to the heart. But does coronary artery bypass surgery also improve erectile capacity?

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Coronary Artery Bypass Graft Diet Heart Disease Risk Factors 52

Open Heart

DECEMBER 6, 2023

Objectives The risk factor-weighted and coronary artery calcium score-weighted clinical likelihood (RF-CL and CACS-CL, respectively) models improve discrimination of patients with suspected obstructive coronary artery disease (CAD). The endpoint was non-fatal myocardial infarction or cardiovascular death.

Coronary Artery Disease 52

Coronary Artery Disease Chest Pain Myocardial Infarction Risk Factors 52

American College of Cardiology

FEBRUARY 1, 2025

Healy, MD, FACC, published an editorial in the New England Journal of Medicine highlighting the findings of two studies in that issue demonstrating clear evidence of sex bias in the management of coronary artery disease.2 That's the only way we can give women a definitive diagnosis for what's causing their chest pain."

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Cardiovascular Disease Education Coronary Artery Disease Risk Factors 44

Wellnest

JULY 19, 2023

Three coronary arteries supply blood to the heart. When one of these arteries becomes completely blocked by a blood clot, it results in a heart attack, also known as MI (Myocardial infarction). The accumulation of cholesterol, foam cells, fibrous tissue, and calcium mainly causes the narrowing of coronary arteries.

Heart Attack 52

Heart Attack Heart attacks Blood Pressure Myocardial Infarction 52

Dr. Smith's ECG Blog

MARCH 14, 2025

He has a history of coronary artery disease and a STEMI two years prior that was treated with primary PCI. He contacted EMS due to acute onset chest pain and feeling unwell and fatigued. He subsequently developed worsening chest pain. He was given ASA and sublingual NTG and taken to the ED.

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Chest Pain STEMI Myocardial Infarction Ischemia 106

Frontiers in Cardiovascular Medicine

MARCH 14, 2025

BackgroundAcute myocardial infarction commonly occurs in patients with coronary artery disease, but rarely, it can develop under a hypercoagulable state. These thrombotic complications predominantly arise in veins rather than in arteries.

Myocardial Infarction 52

Myocardial Infarction Thrombosis Chest Pain Coronary Artery Disease 52

DAIC

OCTOBER 30, 2024

Data confirm the use of FFR CT and Plaque Analysis helps assess long-term risks, informing more personalized and effective treatment plans for patients with coronary artery disease. tim.hodson Wed, 10/30/2024 - 11:23 Oct. 27, 2024 — HeartFlow, Inc.

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Plaque Outcomes Coronary Artery Disease Chest Pain 52