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Electrocardiogram (EKG) was unremarkable. TTE showed a reduced EF with multiple segmental abnormalities concerning for myocardialinfarction. A repeat coronaryangiogram was unremarkable. Circulation, Volume 150, Issue Suppl_1 , Page A4135360-A4135360, November 12, 2024.
Cardiology admitted him for observation with plans for next-day coronaryangiogram. The peak Troponin I confirmed myocardialinfarction. (A Unfortunately, due to the patient’s abrupt exodus from the PCI center – without benefit of coronaryangiogram, or echo, for example – the disposition will forever remain unknown. [1]
Smith , d and Muzaffer Değertekin a DIFOCCULT: DIagnostic accuracy oF electrocardiogram for acute coronary OCClUsion resuLTing in myocardialinfarction. His first electrocardiogram ( ECG) is given below: --Sinus bradycardia. This is a complete coronary occlusion with a good vessel caliber. References 1.
His father and brother both died of myocardialinfarction at ages 61 and 45, respectively. There is appreciable STE aVR with near-global STD that appropriately maximizes in Leads II and V5, and thus suggesting a circumstance of generic, diffusely populated, circumferential subendocardial ischemia versus occlusive coronary thrombus. [1]
Incidence of an acute coronary occlusion. New insights into the use of the 12-lead electrocardiogram for diagnosing acute myocardialinfarction in the emergency department. Incidence of an Acute Coronary Occlusion. Am J Med 2019, 132(5):622-630. Miranda DF, Lobo AS, Walsh B, et al. link] Harhash AA et al.
Cardiology felt her chest pain to be, most likely, the result of coronary supply-demand mismatch in the context of HCM endothelial remodeling (i.e. Type II MI), however decided to pursue coronaryangiogram out of an abundance of caution. A mid-LAD culprit lesion was identified and stented. Pacing Clin Electrophysiol.
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