Dr. Smith's ECG Blog

MARCH 1, 2023

Shortly after receiving epinephrine, the patient developed new leg cramps and chest pain. The chest pain was described as sharp and radiated to both arms. During active chest pain an ECG was recorded: Meyers ECG interpretation: Sinus tachycardia, normal QRS complex, STD in V2-V6, I, II, III and aVF.

Chest Pain 52

Chest Pain Ischemia Tachycardia Stenosis 52

Dr. Smith's ECG Blog

DECEMBER 14, 2022

Sent by Drew Williams, written by Pendell Meyers A man in his 50s with history of hypertension was standing at the bus stop when he developed sudden onset severe pressure-like chest pain radiating to his neck and right arm, associated with dyspnea, diaphoresis, and presyncope. EMS arrived and administered aspirin and nitroglycerin.

Chest Pain 52

Chest Pain STEMI Blog Stenosis 52

Dr. Smith's ECG Blog

SEPTEMBER 18, 2024

Thus, it has recently become generally accepted that most plaque ruptures resulting in myocardial infarction occur in plaques that narrow the lumen diameter by 40% of the arterial cross section may be involved by plaque. The pathologist may see a plaque that constitutes, for example, 50% of the cross-sectional area.

Ischemia 121

Ischemia Plaque Stenosis Myocardial Infarction 121

Dr. Smith's ECG Blog

MAY 20, 2024

A 63 year old man with a history of hypertension, hyperlipidemia, prediabetes, and a family history of CAD developed chest pain, 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.

Chest Pain 124

Chest Pain Blood Pressure Ischemia STEMI 124

DAIC

OCTOBER 16, 2024

15 , 2024 — Four of the seven Medicare Administrative Contractors (MACs) have released final local coverage determinations (LCD) for AI-Coronary Plaque Analysis (AI-CPA). tim.hodson Wed, 10/16/2024 - 12:36 Oct. The four contractors for the U.S.

CMS 52

CMS Medicare Plaque Chest Pain 52

Dr. Smith's ECG Blog

DECEMBER 10, 2019

This is a previously healthy male teenager who was awoken by chest pain. The pain is described as located in the midsternal area, radiating to the right arm, described as 8-9/10 and worse with deep inspirations. In the evening, he became diaphoretic and complained of 9/10 continuous chest pain.

Chest Pain 52

Chest Pain Pericarditis Ischemia Pediatrics 52

Heart BMJ

JANUARY 29, 2024

Clinical introduction Vignette A man in his 40s presented to our emergency department with sudden onset of severe central chest pain radiating to his left arm. The left system showed no disease in the left main stem, but mild plaque disease in the dominant left circumflex artery. There was no antecedent angina.

Chest Pain 40

Chest Pain Angina Ultrasound Plaque 40

Dr. Smith's ECG Blog

APRIL 8, 2022

The ECG is diagnostic for acute transmural infarction of the anterior and lateral walls, with LAD OMI being the most likely cause (which has various potential etiologies for the actual cause of the acute coronary artery occlusion, the most common of which is of course type 1 ACS, plaque rupture with thrombotic occlusion). Is there STEMI?

Chest Pain 52

Chest Pain SCAD STEMI Blog 52

DAIC

JULY 23, 2024

First runner-up for the YIA is Seokhun Yang, MD , of Seoul National University Hospital, for his abstract, “Prognostic Implications Of Coronary CT Angiography-derived Plaque And Hemodynamic Features On Acute Coronary Syndrome Across Varying Time Intervals: Emerald-ii Study.” and the Ma Family, who provided a $5,000 case prize for the winner.

Chest Pain 105

Chest Pain Plaque Coronary Artery Disease Ischemia 105

Dr. Smith's ECG Blog

JULY 31, 2013

A 20-something male presented from an outside facility with Chest pain. He came with this ECG from the outside facility, recorded 1 hour after pain onset: There is at least 2 mm of inferior ST elevation, with reciprocal ST depression in aVL, ST flattening in V4-V6, and T-wave inversion in V2. Vital signs were normal.

Chest Pain 52

Chest Pain Aneurysm STEMI Ischemia 52

Ken Grauer, MD

FEBRUARY 3, 2024

As discussed in detail in ECG Blog #228 — this seemingly qualifies as a “ Silent ” MI ( Approximately half of those MIs not accompanied by CP — have some other associated symptom such as syncope, which substitutes as a “chest pain equivalent” ).

Blog 163

Blog Cardiac Arrest STEMI Plaque 163

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.

Coronary Angiogram 109

Coronary Angiogram Plaque Thrombosis STEMI 109

Heart BMJ

FEBRUARY 23, 2024

In most countries, the pressurised and overcrowded environment of the emergency department serves as the intermediary to discriminate a plaque rupture event from other causes of chest pain. 1 In this.

Myocardial Infarction 52

Myocardial Infarction Chest Pain Plaque 52

DAIC

JANUARY 3, 2024

With more than 500 peer-reviewed publications, the HeartFlow FFR CT Analysis remains unparalleled in precision coronary care, as supported by the ACC/AHA Chest Pain Guidelines, to improve treatment plans and outcomes. 2021 ACC/AHA Chest Pain Guidelines. said John Farquhar, Chief Executive Officer at HeartFlow.

Coronary Artery Disease 59

Coronary Artery Disease Chest Pain Plaque Technology 59

DAIC

APRIL 8, 2024

The study focused on patients who underwent PCI for acute coronary syndromes (ACS)—life-threatening conditions which include heart attacks and chest pain caused by decreased blood flow to the heart—with stents containing drugs to prevent further plaque buildup.

Heart Attack 111

Heart Attack Heart attacks Stent Stents 111

Dr. Smith's ECG Blog

DECEMBER 19, 2023

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 chest pain. He described it as "10/10" intensity, radiating across his chest from right to left. This is written by Willy Frick, an amazing cardiology fellow in St.

Plaque 126

Plaque Angina Blog Stent 126

Dr. Smith's ECG Blog

MARCH 17, 2024

He also complained of intermittent mild chest pain radiating into into both shoulders and his back, as well as occasional unexplained sweating. He had no further chest pain. He described mild substernal chest pain, again radiating into both shoulders with occasional sweating. The name is self-explanatory.

Angina 70

Angina Chest Pain Blog Ischemia 70

Dr. Smith's ECG Blog

SEPTEMBER 22, 2023

Here is the clinical story: A 40 year old male with no cardiac history presented with acute substernal chest pain that started 40 minutes prior to arrival. In spite of a relatively short QTc of 376 ms, the very low R-wave amplitude in V4 and the ST Elevation at 60 ms after the J-point in lead V3 contribute to a high final value.

STEMI 129

STEMI Stenosis Plaque Chest Pain 129

Dr. Smith's ECG Blog

JANUARY 5, 2024

The patient said his chest pain was 4/10, down from 8/10 on presentation. Although it is statistically unlikely, multiple plaque ruptures are possible. The PDA plaque was also bulky, but was not described as inflamed or ulcerated. The PDA plaque was also bulky, but was not described as inflamed or ulcerated.

Angina 119

Angina Plaque Document Stent 119

EMS 12-Lead

APRIL 9, 2024

There was no chest pain. V1 and V2 are probably placed too high on the chest given close morphological similarity to aVR. Sudden narrowing of a coronary artery due to ACS (plaque rupture with thrombosis and/or downstream showering of platelet-fibrin aggregates). The fall was not a mechanical etiology. Type I ischemia.

Ischemia 116

Ischemia Stenosis Chest Pain Coronary Artery Disease 116

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

NOVEMBER 3, 2023

A man in his 70s with past medical history of hypertension, dyslipidemia, CAD s/p left circumflex stent 2 years prior presented to the ED with worsening intermittent exertional chest pain relieved by rest. This episode of chest pain began 3 hours ago and was persistent even at rest. Troponin was ordered.

Chest Pain 81

Chest Pain Cardiogenic Shock Ischemia Myocardial Infarction 81

Dr. S. Venkatesan MD

FEBRUARY 25, 2024

However ,we have some effective clinical and pathological markers too, for effective re-vascularisation They are clinical well being and good functional capacity , relief from chest-pain, reduction of plaque volume, plaque stabilisation, maintenance of collaterals , microvascular patency , reduction of recurrent events.

Chest Pain 59

Chest Pain Plaque Stent Stents 59

Dr. Smith's ECG Blog

SEPTEMBER 9, 2024

Written by Willy Frick A 40 year old woman was at home cooking when she developed chest pain. Smith comment : a very high proportion of MINOCA are ruptured plaque with lysed thrombus. That plaque is at risk of thrombosing again. An angiogram is a " lumenogram " and does not "see" the extraluminal plaque.

Plaque 65

Plaque Stent Stents Chest Pain 65

MIBHS

JULY 31, 2024

Sustained inflammation can damage your blood vessels, leading to atherosclerosis (plaque buildup) and increasing your risk of heart attack and stroke. This can lead to chest pain (angina) and increase your risk of heart attack or stroke, especially if you already have underlying heart disease.

Blood Pressure 52

Blood Pressure Heart Attack Heart attacks Heart Rhythm 52

Dr. Sanjay Gupta

DECEMBER 19, 2022

She asked me why I felt she had had a heart attack and I explained to her that she had had chest pains and the blood test indicating damage to the heart was elevated and that was all we needed to say that she had had a heart attack. On the basis of these findings we told her that she had suffered a heart attack.

Heart Attack 40

Heart Attack Heart attacks Blood Clot Chest Pain 40

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

FEBRUARY 20, 2009

Here is a case of an 89 year old woman who had syncope but no chest pain or shortness of breath. There was a ruptured plaque with thrombus in the LAD, with some flow still (accounting for the inverted T waves). Her initial EKG (#1) shows some ST depression in V4-V6, possibly ischemic or possibly due to LVH.

Chest Pain 52

Chest Pain STEMI Ischemia Plaque 52

MIBHS

DECEMBER 27, 2024

This condition occurs when the blood vessels that supply blood to the heart become blocked or narrowed by plaque buildup. As a result, the heart doesnt receive enough oxygen-rich blood, which can lead to chest pain, shortness of breath, or even a heart attack.

Coronary Artery Bypass Graft 52

Coronary Artery Bypass Graft Open-Heart Surgery Kidney Disease Chronic Disease 52

Circulation

NOVEMBER 11, 2024

Description of Case:A 64-year-old male with complex medical history, including infective endocarditis of the aortic valve requiring surgical replacement with a bioprosthetic valve and recurrent infective endocarditis of the bioprosthetic valve, presented with two hours of crushing chest pain and found to have ST elevations.

Aortic valve 40

Aortic valve TAVR Chest Pain Aortic 40

Circulation

NOVEMBER 11, 2024

We present a complex case of NSTEMI with multi-vessel coronary artery disease treated with PCI via the Carlino technique.Case Description:A 60-year-old female with a history of hypertension, diabetes mellitus, and ischemic heart disease presented with severe chest pain that radiated to the neck and was associated with nausea and vomiting.

Coronary Artery Disease 40

Coronary Artery Disease Chest Pain Myocardial Infarction Thrombolysis 40

All About Cardiovascular System and Disorders

APRIL 17, 2024

CT coronary angiogram is useful to rule out significant blocks in in those presenting with chest pain to the emergency department. But it may not be that useful just to screen for blocks or build-up of plaques in those without any symptoms. Detection of minor plaques in those persons might lead on to undue anxiety.

Coronary Angiogram 40

Coronary Angiogram Catheterization Laboratory Angioplasty Chest Pain 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

IntroductionAtherosclerosis, the hardening and narrowing of the arteries, occurs due to the buildup of plaque on the inner walls of the arteries which can result in reduced blood flow to the organs and tissues. Risk factors such as smoking, chronic kidney disease, and aging can contribute to plaque formation.

Risk Factors 40

Risk Factors Blood Pressure Chest Pain Plaque 40

Dr. Smith's ECG Blog

SEPTEMBER 20, 2011

He did not state he had chest pain, but, then again, he couldn't remember anything. The ECG and ultrasound could not have been differentiated from acute plaque rupture with occlusion of the RCA. This 80 year old with a history of CABG had a cardiac arrest. There is concordant ST elevation in all inferior leads.

Cardiac Arrest 52

Cardiac Arrest STEMI Ultrasound Chest Pain 52

AMS Cardiology

AUGUST 15, 2023

High cholesterol levels – Elevated levels of bad cholesterol can contribute to plaque buildup in your arteries, increasing the risk of heart disease. Routine blood pressure checks are essential to maintaining a healthy heart as high blood pressure often has no symptoms.

Heart Disease 52

Heart Disease Blood Pressure Risk Factors Cholesterol 52

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

A 69‐year‐old woman with a history of lung cancer, hypertension, chronic tobacco use, atherosclerosis, and known calcified plaque at the left carotid bifurcation on dual antiplatelet therapy presented with acute onset of expressive aphasia and right hemiparesis due to acute left CCAO.

Outcomes 40

Outcomes Chest Pain Coronary Artery Disease Aortic 40

Dr. Smith's ECG Blog

MARCH 27, 2018

The chief complaint was "chest pain." Male patient: I went back to the room of the first patient and he stated that he had been having chest pain on and off for 3 days. It was actually a dissection, not an atherosclerotic plaque rupture. Two Cases Male Patient I was handed this ECG of a 40-something male patient.

Chest Pain 52

Chest Pain Myocardial Infarction Plaque STEMI 52