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Written by Jesse McLaren, with comments from Smith and Grauer A 60 year old presented with three weeks of intermittent non-exertional chestpain without associated symptoms. A prospective validation of the HEART score for chestpain patients at the emergency department. Backus BE, Six AJ, Kelder JC, et al.
PCI is commonly used to open blocked arteries to treat significant myocardial ischemia , which occurs when the heart muscle does not get enough oxygenated blood. Half of the participants were randomly assigned to receive PCI plus medical therapy and half received medical therapy alone.
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 chestpain, weakness and nausea. The ECG cannot diagnose the etiology of ischemia; it only the presence of ischemia, from whatever etiology.
24 will focus on the following three current guideline updates: American College of Cardiology (ACC)/American Heart Association (AHA) Guidelines 2023 Atrial Fibrillation Guideline - Pharmacology II: Strokes vs. Bleeds, What Do the Guidelines Tell Us About Practical Management in A-fib? The Guidelines Sessions at ACC.24
Given her reported chestpain, shortness of breath, and syncope, an ECG was quickly obtained: What do you think? Alternation in ST segment appearance ( or in the amount of ST elevation or depression ) — is often linked to ischemia. She was noted to be tachycardic and her heart sounds were distant on physical exam.
In MSIMI (Mental Stress-induced Myocardial Ischemia) studies , mental stress activities like public speaking were evaluated for their impact on ischemia, measured via myocardial SPECT and vascular function (microvascular function, endothelial function). Combining behavioral and pharmacological treatment is most effective.
A late middle-aged man presented with one hour of chestpain. If there is polymorphic VT with a long QT on the baseline ECG, then generally we call that Torsades, but Non-Torsades Polymorphic VT can result from ischemia alone. Most recent echo showed EF of 60%. He also had a history of chronic kidney disease, stage III.
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