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Post cath ECG: Now there are hyperacute T-waves again, and recurrent ST depression in V2 This ECG would normally diagnostic of OMI until proven otherwise No further troponins were measured, but it looks like there is recurrent OMI Next day: A CT CoronaryAngiogram was done (CTCA) CARDIAC MORPHOLOGY AND FUNCTION: 1. Circulation.
Circulation, Volume 150, Issue Suppl_1 , Page A4142716-A4142716, November 12, 2024. Background:Heavily calcified coronary bifurcation lesions present significant challenges during percutaneous coronary intervention, particularly during atherectomy due to the risk of side branch occlusion from plaque shift.
Circulation, Volume 150, Issue Suppl_1 , Page A4142012-A4142012, November 12, 2024. Coronary angiography revealed a tortuous and extremely aneurysmal RCA, as well as multivessel coronary artery disease (mvCAD) involving LAD, D1, LCx, OM1. Notably, the LAD had multiple aneurysmal segments and areas of eccentric stenosis upto 90%.Multislice
She had a prior history of "NSTEMI" one month ago, during which she had a coronaryangiogram reportedly showing no stenosis in any coronary artery. This case was published in Circulation on January 22, 2018 (thanks to Brooks Walsh for finding this!) link] Circulation. Her vitals were within normal limits.
The diagnostic coronaryangiogram identified only minimal coronary artery disease, but there was a severely calcified, ‘immobile’ aortic valve. Aortic angiogram did not reveal aortic dissection. Oxygen supply is determined by: 1) oxygen carrying capacity, 2) O2 saturation, and 3) Coronary flow.
The coronaryangiogram revealed no critical stenosis, or acute plaque ulceration. Takotsubo should be a diagnosis of exclusion after angiography reveals no obstructive coronary disease, and repeat Echo displays left ventricular recovery. Circulation, Vol 137, No 11, 1192-94. Circulation, Vol 139, No 16, 1974-76.
On the other hand, the murmur in valvular aortic stenosis does not change substantially or decreases slightly following the Valsalva maneuver. Circulation. Of note, that the clinical suspicion warrants an echocardiographic evaluation of the left ventricle for septal hypertrophy and elevated gradients. Hypertrophic cardiomyopathy.
More troponin values were measured at the cardiac center: 2327- 267 ng/L 0821- 355 ng/L 1108- 305 ng/L An echocardiogram on day three of the patients admission showed an ejection fraction of 46% with abnormal basal inferior and basal lateral segments, and severe aortic stenosis. What "initiates" the aortic stenosis cascade?
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