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Category 1 : Sudden narrowing of a coronary artery due to ACS (plaque rupture with thrombosis and/or downstream showering of platelet-fibrin aggregates. It’s judicious, then, to arrange for coronaryangiogram. Proximal LAD disease with/without a) and b) It seemed quite apparent that this was an Acute Coronary Syndrome.
Indeed, bedside Echocardiogram revealed severe left ventricular impairment of Takotsubo cardiomyopathy. The coronaryangiogram revealed no critical stenosis, or acute plaque ulceration. Furthermore, pertinent electrolyte values (e.g. potassium) were within normal parameter.
See this case: what do you think the echocardiogram shows in this case? We investigated the incidence of an acutely occluded coronary in patients presenting with STE-aVR with multi-lead ST depression. All electrocardiograms (ECGs) and coronaryangiograms were blindly analyzed by experienced cardiologists.
CT coronaryangiogram showed a hypoplastic RCA and dominant LCx. There were no plaques or stenoses. It is reasonable to perform an echocardiogram to evaluate LV function. A workup was undertaken in search of a cause of the patient's ventricular arrhythmia. As noted above echocardiography was completely normal.
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