Dr. Smith's ECG Blog
NOVEMBER 15, 2023
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 Coronary Angiogram was done (CTCA) CARDIAC MORPHOLOGY AND FUNCTION: 1. IMPRESSION: 1.
Dr. S. Venkatesan MD
JUNE 26, 2024
Wuhan Asia Heart Hospital, Wuhan, China Did you guess the diagnosis correctly? It is an acceptable diagnosis, if you thought an anomalous LCA, a LAD CTO or a single coronary artery. Video source and courtesy: Leizhi Ku,, Xiaojing Ma, From the Departments of Radiology (L.K.) and Echocardiography (X.M.), It is left main atresia.
Dr. Smith's ECG Blog
MAY 20, 2024
So the patient was admitted to the hospital with no plan for an angiogram. The Queen of Hearts now sees no OMI with low confidence: The patient did not receive an angiogram on day two of his hospitalization because the cath lab was too busy. Instead he had an angiogram at 0800 on day 3. Smith: What???!!!
Dr. Smith's ECG Blog
DECEMBER 9, 2023
A Coronary angiogram from 8 years prior revealed that he had had an inferior posterior STEMI at the time due to 100% occlusion of the proximal RCA. The above said — I thought it may be insightful to review the initial pre-hospital ECG , which has to be interpreted as an acute OMI until proven otherwise.
Dr. Smith's ECG Blog
JULY 2, 2023
This was texted to me from a former resident, while working at a small rural hospital, with the statement: "I can’t convince myself of anything here, but he’s a 63-year-old guy with prior stents and a good story for ACS." We don't know if he had a stress test, a CT Coronary angiogram, or they just decided to do an angiogram.
EMS 12-Lead
JULY 24, 2023
It’s judicious, then, to arrange for coronary angiogram. Coronary occlusion, however, might be present concurrently with subendocardial ischemia on the time-zero ECG, or evolve into such. Proximal LAD disease with/without a) and b) It seemed quite apparent that this was an Acute Coronary Syndrome. Coronary Angiogram 1.
Ken Grauer, MD
FEBRUARY 24, 2023
Hospital evaluation for this patient was negative for an acute coronary syndrome ( ie, CT coronary angiogram was normal — troponin was not elevated — and Echo was negative, with no sign of pericardial effusion ). CT Coronary Angiogram showed no sign of underlying coronary disease.
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