Coronary Angiogram STEMI Stents 
Dr. S. Venkatesan MD
JUNE 26, 2024
Final message Coronary arterial anomaly is a less discussed topic nowadays, unless & until, it intrudes an interventional cardiologist in his daily routine life, of delivering stents. We know, how adverse is the outcome of Left main STEMI. In reality, there could be thousands of asymptomatic ones in the public domain.
Dr. Smith's ECG Blog
MAY 10, 2023
A CT Coronary angiogram was ordered. Here are the results: --Minimally obstructive coronary artery disease. --LAD Although a lesion is not visible anatomically on this CT scan, coronary catheter angiography could be considered based on Cardiology evaluation." Transient STEMI is at high risk of re-occlusion.
Dr. Smith's ECG Blog
JUNE 19, 2023
This ECG was read as “No STEMI” with no prior available for comparison. It is true this ECG does not meet STEMI criteria (there is 1.0 The Queen of Hearts sees it of course: Still none of these three ECGs meet STEMI criteria. Two stents were placed with resultant TIMI 3 flow. What do you think? Of course not.
Dr. Smith's ECG Blog
DECEMBER 22, 2022
Here is the coronary angiogram: A distal thrombotic right coronary artery (RCA) occlusion ! The lesion was successfully stented. Here is the post-intervention angiogram and post-PCI ECG. Here is the post-intervention angiogram and post-PCI ECG. The pain was completely resolved after coronary intervention.
Dr. Smith's ECG Blog
MAY 20, 2024
The cardiologist recognized that there were EKG changes, but did not take the patient for emergent catheterization because the EKG was “not meeting criteria for STEMI”. Troponin was elevated and no “STEMI” was seen on the EKG, so if it is acute MI, then “NSTEMI” is the diagnosis (however flawed), not a pathology on the differential.
EMS 12-Lead
MARCH 19, 2023
He denied any known medical history, specifically: coronary artery disease, hypertension, dyslipidemia, diabetes, heart failure, myocardial infarction, or any prior PCI/stent. It doesn’t meet any conventional STEMI criteria, but there is patently obvious increased area under the curve. No appreciable skin pallor. Is this OMI?
EMS 12-Lead
MAY 20, 2022
This worried the crew of potential acute coronary syndrome and STEMI was activated pre-hospital. As it currently stands, an ST/S ratio >15% should raise awareness for new anterior STEMI. Type II MI), however decided to pursue coronary angiogram out of an abundance of caution.
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