Coronary Angiogram Ischemia Ultrasound 
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. Smith's ECG Blog
MAY 20, 2024
This EKG is diagnostic of transmural ischemia of the inferior wall. If it is angina, lowering the BP with IV Nitroglycerine may completely alleviate the pain and the (unseen) ECG ischemia. Transmural ischemia (as seen with the OMI findings on ECG) is not very common with demand ischemia, but is possible.
Dr. Smith's ECG Blog
JANUARY 2, 2025
Bedside cardiac ultrasound showed moderately decreased LV function. Finally, do a coronary angiogram Possible alternative to pacing is to give a beta-1 agonist to increase heart rate. She was intubated. CT of the chest showed no pulmonary embolism but bibasilar infiltrates. Dobutamine is an acceptable alternative.
Dr. Smith's ECG Blog
NOVEMBER 19, 2016
Smith comment: This patient did not have a bedside ultrasound. Had one been done, it would have shown a feature that is apparent on this ultrasound (however, this patient's LV function would not be as good as in this clip): This is recorded with the LV on the right. Aortic angiogram did not reveal aortic dissection.
Dr. Smith's ECG Blog
NOVEMBER 4, 2022
His response: “subendocardial ischemia. Smith : It should be noted that, in subendocardial ischemia, in contrast to OMI, absence of wall motion abnormality is common. With the history of Afib, CTA abdomen was ordered to r/o mesenteric ischemia vs ischemic colitis vs small bowel obstruction. Anything more on history?
Dr. Smith's ECG Blog
JANUARY 9, 2023
Beware a negative Bedside ultrasound. Young people can suffer acute coronary occlusion, whether by typical atherosclerotic plaque rupture, or by coronary anomalies, coronary aneurysms, dissections, spasm, etc. Chest Pain in a Male in his 20's; Inferior ST elevation: Inferior lead "early repol" diagnosed. Pericarditis?
Dr. Smith's ECG Blog
DECEMBER 16, 2024
But it also shows a massive area of total ischemia in the LAD territory: CT shows the infarct The CT is with contrast, which increases density (which looks more white). Angiogram Door to balloon time was 120 minutes (much too long) because of time taken for a CT. And almost all of them could be detected by bedside ultrasound.
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