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Angiogram-derived physiology: will it change the game or miss the boat?

Heart BMJ

The authors logically suggest that the data, taken in the context of promising clinical results from this and other angiogram-derived physiology systems, indicate that vFFR should be used more routinely in clinical practice to improve the precision of patient diagnosis and management.

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Systematic coronary physiology improves level of agreement in diagnostic coronary angiography

Open Heart

Objective The training of interventional cardiologists (ICs), non-interventional cardiologists (NICs) and cardiac surgeons (CSs) differs, and this may be reflected in their interpretation of invasive coronary angiography (ICA) and management plan. Trial registration number NCT01070771.

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Distractions

EMS 12-Lead

Another factor to be considered, according to Chou’s textbook, is that many patients have dual AVN physiology and conduction is preferential down the fast pathway. Learning points 1] Acute Coronary Syndrome has many shades of clinical manifestation. Quite frankly, none of this matters acutely!

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What Lies Beneath

EMS 12-Lead

The combination of prolonged QT and deep T wave inversion throughout the precordium is typical of Takotsubo syndrome, or Stress Cardiomyopathy – which can occur in the context of a physiologically distressed ICU patient, further compromising their hemodynamics. The coronary angiogram revealed no critical stenosis, or acute plaque ulceration.

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Diffuse Subendocardial Ischemia on the ECG. Left main? 3-vessel disease? No!

Dr. Smith's ECG Blog

The diagnostic coronary angiogram identified only minimal coronary artery disease, but there was a severely calcified, ‘immobile’ aortic valve. Aortic angiogram did not reveal aortic dissection. Any alteration in physiology can change "compensated" AS to "decompensated" AS. Am J Cardiol 2011;107:495-500.