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A 60-something yo female presented w/ exertional chestpain for 3 days. Pain was 8/10 and constant. She has been experiencing progressively worsening exertional dyspnea and chest tightness mostly when climbing up flights of stairs since early September. But the patient has active chestpain.
[link] A 30 year-old woman was brought to the ED with chestpain. She had given birth a week ago, and she had similar chestpain during her labor. She attributed the chestpain to anxiety and stress, saying "I'm just an anxious person." The initial troponin I was elevated at 0.75
link] A 62 year old man with a history of hypertension, type 2 diabetes mellitus, and carotid artery stenosis called 911 at 9:30 in the morning with complaint of chestpain. He described it as "10/10" intensity, radiating across his chest from right to left. His echocardiogram showed normal wall motion. It is not rare.
Written by Willy Frick A 40 year old woman was at home cooking when she developed chestpain. The patient was thought to have low likelihood of ACS, and cardiology recommended repeat troponin, urine drug testing, and echocardiogram. Bedside echocardiogram showed hypokinesis of the mid to distal anterior wall and apex.
This patient, who is a mid 60s female with a history of hypertension, hyperlipidemia and GERD, called 911 because of chestpain. A mid 60s woman with history of hypertension, hyperlipidemia, and GERD called 911 for chestpain. It is also NOT the clinical scenario of takotsubo (a week of intermittent chestpain).
No patient with chestpain should be sent home without troponin testing. The scan did not find PE, but showed evidence of coronary plaque: There are areas of dense white in the LAD (red and blue circles) and in the first diagonal (green circle). An echocardiogram showed an EF of 20-25%.
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. Echocardiogram findings (pre-procedure) 1. A 12 Lead ECG was captured on her arrival. Severe Hypoxia b.
These are reperfusion T-waves (the same thing as Wellens' waves) Echocardiogram Regional wall motion abnormality-distal septum and apex. While ST coving in V1 is not necessarily abnormal — the presence of ST elevation in association with ST-T wave abnormalities in V2,V3 in a patient with chestpain is clearly cause for concern.
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. See this case: what do you think the echocardiogram shows in this case?
Angiogram: Severe coronary artery calcification Moderate to severe distal small vessel disease mainly seen in RPL1, 2 Otherwise, Mild plaque, no angiographically significant obstructive coronary artery disease. Echocardiogram: Estimated left ventricular ejection fraction, lower limits of normal; 45-50%.
Echocardiogram showed LVEF 66% with normal wall motion and normal diastolic function. He did not remember whether he had experienced any chestpain. Two subsequent troponins were down trending. Within a few days, the patient was extubated and was neurologically intact.
They had difficulty describing their symptoms, but complained of severe weakness, nausea, vomiting, headache, and chestpain. They described the chestpain as severe, crushing, and non-radiating. Altogether, this strongly suggests inferolateral OMI, particularly in a patient with acute chestpain.
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. Chest X-Ray A chest X-ray is often the first imaging test conducted, as it can reveal whether the heart is enlarged and by how much.
However, an echocardiogram is a different test, also conducted for heart activity. If you experience any symptoms, such as chestpain, dizziness, unusual tiredness or fatigue, shortness of breath, or irregular heartbeat, your doctor would want you to go for an ECG test to find out the underlying cause.
He denied chestpain. In this study of consecutive patients with LBBB who were hospitalized and had an echocardiogram, a QRS duration less than 170 ms (n = 262), vs. greater than 170 ms (n = 38), was associated with a significantly better ejection fraction (36% vs. 24%). So indeed the QRS is approximately 200 ms.
Written by Willy Frick A man in his 60s with a history of hypertension and 40 pack-year history presented to the ER with 1 day of intermittent, burning substernal chestpain radiating into both arms as well as his back and jaw. Echocardiogram showed inferior hypokinesis. Troponin was rising when last checked, 8928 ng/L.
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