Chest Pain Stenosis Thrombosis 
Dr. Smith's ECG Blog
JANUARY 27, 2024
Written by Jesse McLaren, comments by Smith A 55 year old with a history of NSTEMI presented with two hours of exertional chest pain, with normal vitals. Old ‘NSTEMI’ A history of coronary artery disease and a stent to the same territory further increases pre-test likelihood of acute coronary occlusion, including in-stent thrombosis.
Dr. Smith's ECG Blog
SEPTEMBER 18, 2024
Since the pathologist does not know the original cross-sectional area of the artery or the amount of compensatory enlargement of the artery from evaluation of a single cross section of the artery at a site of stenosis, the degree of luminal narrowing of that segment cannot be determined. These are typical findings at sites of plaque rupture.
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. The LM has an irregular 30% distal stenosis, followed by an 80% ostial LAD stenosis, and total occlusion of the LAD proximally with TIMI grade 1 flow in the distal vessel. Type I ischemia.
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.
Dr. Smith's ECG Blog
SEPTEMBER 5, 2023
A 60-something awoke with 10/10 crushing chest pain. The angiogram showed an open artery with 95% stenosis and thrombosis and it was stented. But the patient's chest pain continues and so you order a 2nd ECG (ECG 2 here). He walked in to triage. I would expect that a stent would be placed.
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).
EMS 12-Lead
JULY 24, 2023
But the symptoms returned with similar pattern – provoked by exertion, and alleviated with rest; except that on each occasion the chest pain was a little more intense, and the needed recovery period was longer in duration. Aortic Stenosis f. Left Main stenosis (not thrombosed) c. Left Main stenosis (not thrombosed) c.
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