Coronary Angiogram and Plaque - Cardiovascular Update

What does the angiogram show? The Echo? The CT coronary angiogram? How do you explain this?

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.

Coronary Angiogram

Coronary Angiogram Plaque Thrombosis STEMI

Who Needs a CT Coronary Angiogram?

All About Cardiovascular System and Disorders

APRIL 17, 2024

CT coronary angiograms are increasing in popularity as a non-invasive screening test for detecting blocks in coronary arteries. Coronary arteries are blood vessels supplying oxygenated blood to the heart. Angiograms are images of blood vessels, usually obtained by injecting medications for contrast from body structures.

Coronary Angiogram

Coronary Angiogram Catheterization Laboratory Angioplasty Chest Pain

How To Reverse Coronary Artery Disease With Lifestyle Measures

Dr. Paddy Barrett

DECEMBER 19, 2023

Reversing or regressing coronary artery disease is possible. You cannot eliminate the plaque entirely, but multiple clinical trials have shown plaque regression using high-intensity cholesterol-lowering treatments, which I have discussed previously. REVERSAL Investigators. 2004 Mar 3;291(9):1071-80.

Coronary Artery Disease

Coronary Artery Disease Plaque Exercise Heart Attack

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A 30-something woman with intermittent CP, a HEART score of 2 and a Negative CT Coronary Angiogram on the same day

Dr. Smith's ECG Blog

MAY 10, 2023

A CT Coronary angiogram was ordered. Here are the results: --Minimally obstructive coronary artery disease. --LAD LAD plaque with 0-25 percent stenosis. Although a lesion is not visible anatomically on this CT scan, coronary catheter angiography could be considered based on Cardiology evaluation."

Coronary Angiogram

Coronary Angiogram Chest Pain Stenosis STEMI

An undergraduate who is an EKG tech sees something. The computer calls it completely normal. How about the physicians?

Dr. Smith's ECG Blog

MAY 20, 2024

The scan also showed “scattered coronary artery plaques”. __ Smith comment 1 : the appropriate management at this point is to lower the blood pressure (lower afterload, which increases myocardial oxygen demand). Smith comment : Is the ACS (rupture plaque) with occlusion that is now reperfusing?

Chest Pain

Chest Pain Blood Pressure Ischemia STEMI

Abstract 4142716: Double Guiding Catheter Technique for Orbital Atherectomy in a Heavily Calcified Coronary Bifurcation Using Microcatheter Protection for Non-atherectomy Wire

Circulation

NOVEMBER 11, 2024

Background:Heavily calcified coronary bifurcation lesions present significant challenges during percutaneous coronary intervention, particularly during atherectomy due to the risk of side branch occlusion from plaque shift. Case:A 74-year-old male with a recent NSTEMI presented for elective coronary artery revascularization.

Coronary Angiogram

Coronary Angiogram Stenosis Plaque Stents

Critical Left Main

EMS 12-Lead

JULY 24, 2023

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 coronary angiogram. Proximal LAD disease with/without a) and b) It seemed quite apparent that this was an Acute Coronary Syndrome.

Angina

Angina Ischemia Coronary Angiogram Stenosis

Should You Take A Statin To Lower Your Cholesterol?

Dr. Paddy Barrett

NOVEMBER 8, 2024

The most accurate way (But not the only way) to answer this question is whether or not you have plaque in your coronary arteries. If you already have plaque, your risk of event an event goes up proportional to the amount of plaque you have 2. So, low risk by anyone’s books.

Cholesterol

Cholesterol Plaque Heart Attack Heart attacks

What Lies Beneath

EMS 12-Lead

AUGUST 22, 2022

The coronary angiogram revealed no critical stenosis, or acute plaque ulceration. Takotsubo should be a diagnosis of exclusion after angiography reveals no obstructive coronary disease, and repeat Echo displays left ventricular recovery. Furthermore, pertinent electrolyte values (e.g.

Tachycardia

Tachycardia Cardiomyopathy Electrophysiology ICU

90 year old with acute chest and epigastric pain, and diffuse ST depression with reciprocal STE in aVR: activate the cath lab?

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

We investigated the incidence of an acutely occluded coronary in patients presenting with STE-aVR with multi-lead ST depression. All electrocardiograms (ECGs) and coronary angiograms were blindly analyzed by experienced cardiologists.

Ischemia

Ischemia STEMI Stenosis Chest Pain

In Your 40s to 60s And Worried About Heart Disease? Here Is What You Can Do.

Dr. Paddy Barrett

JANUARY 30, 2024

Subscribe now Cardiac CT There are two types of cardiac CT: CT Coronary Artery Calcium (CAC) Scan CT Coronary Angiogram (CTCA). The CAC scan looks for deposits of calcium in the areas of the coronary arteries as a proxy marker for plaque. It’s not a good test for assessing for plaque in the arteries.

Heart Disease

Heart Disease Heart Attack Heart attacks Plaque

The Advantages Of A CT Coronary Angiogram

Dr. Paddy Barrett

AUGUST 1, 2023

A CTCA provides much more anatomical detail and can identify advanced plaque often missed by CT Coronary Artery Calcium Score scans alone. CT Coronary Artery Calcium Score Scan CT Coronary Artery Calcium Score CT Coronary Angiogram As you can see from the above images, the CTCA provides far more anatomical detail.

Coronary Angiogram

Coronary Angiogram Plaque Coronary Artery Disease Chest Pain

Intravascular Imaging Can Improve Outcomes for Complex Stenting Procedures

DAIC

APRIL 2, 2025

Angiography has limitations that make it difficult to determine the true artery size and the makeup of the plaque, and is suboptimal in determining whether the stent is fully expanded post-PCI and identifying other complications that affect the safety and effectiveness of the procedure.

Stents

Stents Stent Outcomes Coronary Angiogram

A teenager with chest pain, a troponin below the limit of detection, and "benign early repolarization"

Dr. Smith's ECG Blog

JANUARY 9, 2023

Only after her troponin peaked at 500,000 ng/L did she get her angiogram, which showed a 100% left main occlusion due to ruptured plaque. Young people can suffer acute coronary occlusion, whether by typical atherosclerotic plaque rupture, or by coronary anomalies, coronary aneurysms, dissections, spasm, etc.

Chest Pain

Chest Pain Aneurysm STEMI Thrombosis

Why You Probably Already Have Heart Disease But Just Don't Know It.

Dr. Paddy Barrett

MAY 31, 2024

Heart disease, the build-up of plaque in the coronary arteries, typically starts years, if not decades, prior to an event. The most common way to assess the presence and extent of coronary artery disease is with a CT scan, called a CT CAC score or CT Coronary Angiogram. CT Coronary Angiogram.

Heart Disease

Heart Disease Plaque Heart Attack Heart attacks

Trust the coronaries : There are benign forms of ACS too !

Dr. S. Venkatesan MD

JANUARY 22, 2025

In these patients there is no plaque triggered ACS. we can witness menacingly deep resting ST depression with absolutely no thrombotic process going on in the coronary. Mind you, even a coronary angiogram will not bail you out in terms of decision-making and risk prediction.

Coronary Angiogram

Coronary Angiogram Chest Pain Anatomy Angina

Which patient needs a CT scan?

Dr. Smith's ECG Blog

DECEMBER 16, 2024

Angiogram Door to balloon time was 120 minutes (much too long) because of time taken for a CT. Coronary angiogram showed 100% mid LAD occlusion for which she received a DES with excellent angiographic result. This was ruptured plaque with thrombus.

Chest Pain

Chest Pain STEMI Aortic Ultrasound

Electrical instability in a healthy 50 year old. How to manage?

Dr. Smith's ECG Blog

FEBRUARY 6, 2025

CT coronary angiogram showed a hypoplastic RCA and dominant LCx. There were no plaques or stenoses. A workup was undertaken in search of a cause of the patient's ventricular arrhythmia. As noted above echocardiography was completely normal. Once the arrhythmia was under control cardiac MRi was performed.

Tachycardia

Tachycardia Arrhythmia Ablation Atrial Flutter

What does the angiogram show? The Echo? The CT coronary angiogram? How do you explain this?

Who Needs a CT Coronary Angiogram?

How To Reverse Coronary Artery Disease With Lifestyle Measures

Webinars

A 30-something woman with intermittent CP, a HEART score of 2 and a Negative CT Coronary Angiogram on the same day

An undergraduate who is an EKG tech sees something. The computer calls it completely normal. How about the physicians?

Abstract 4142716: Double Guiding Catheter Technique for Orbital Atherectomy in a Heavily Calcified Coronary Bifurcation Using Microcatheter Protection for Non-atherectomy Wire

Critical Left Main

Should You Take A Statin To Lower Your Cholesterol?

What Lies Beneath

90 year old with acute chest and epigastric pain, and diffuse ST depression with reciprocal STE in aVR: activate the cath lab?

In Your 40s to 60s And Worried About Heart Disease? Here Is What You Can Do.

The Advantages Of A CT Coronary Angiogram

Intravascular Imaging Can Improve Outcomes for Complex Stenting Procedures

A teenager with chest pain, a troponin below the limit of detection, and "benign early repolarization"

Why You Probably Already Have Heart Disease But Just Don't Know It.

Trust the coronaries : There are benign forms of ACS too !

Which patient needs a CT scan?

Electrical instability in a healthy 50 year old. How to manage?

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