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Previous medical interventions included a spectrum of procedures, including catheter-directed thrombectomy for popliteal artery aneurysms with thrombosis, vascular bypass grafting for cerebral-anterior communicating artery aneurysms and arch replacement and stent implantation for aortic dissecting aneurysms.
This was a male in his 50's with a history of hypertension and possible diabetes mellitus who presented to the emergency department with a history of squeezing chestpain, lasting 5 minutes at a time, with several episodes over the past couple of months. Plan was for admission for chestpain workup. Jernberg T, et al.
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).
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.
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.
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.
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?
No chestpain. I think a good start would be a posterior EKG and a high quality contrast echocardiogram read by an expert. His inpatient clinicians did not think that an urgent angiogram was warranted given that he was chestpain free, his EKG appeared nondiagnostic, and serial troponins were not elevating beyond 2 ug/L.
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.
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