Coronary Angiogram and Stenosis - 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

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. The LAD has moderate 40% ostial-proximal LAD stenosis and severe 90% mid LAD stenosis involving first diagonal branch. --The CAD-RADS category 1. --No

Coronary Angiogram

Coronary Angiogram Chest Pain Stenosis STEMI

Reoperative minimal invasive off-pump coronary artery bypass graft in early left main stem stenosis following Modified Bentall procedure

Journal of Cardiothoracic Surgery

DECEMBER 18, 2024

CT coronary angiogram revealed severe narrowing of the left main coronary artery. Six months following modified Bentall procedure a patient presented with angina and acute ST depression. Minimal invasive off p.

Coronary Artery Bypass Graft

Coronary Artery Bypass Graft Coronary Angiogram Angina Stenosis

Operator decision-making in angiography-only guided revascularization for lesions not indicated for FFR: a QFR-based functional assessment in chronic coronary syndrome

Frontiers in Cardiovascular Medicine

FEBRUARY 25, 2024

Methods This single-center prospective registry included consecutive patients with chronic coronary syndrome (CCS) who underwent elective coronary angiography, with or without revascularization. Average diameter stenosis (DS) was 37 ± 34%, and QFR was 0.87 ± 0.15, demonstrating a moderate correlation ( r = −0.84; 95% CI: −0.86

Coronary Angiogram

Coronary Angiogram Stenosis

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

Or is it a very tight stenosis that does not allow enough flow to perfuse myocardium that has a high oxygen demand from severely elevated BP? The T waves in leads II and aVF have deflated, and the T wave in lead III has become terminally negative. The ST depressions in I and aVL have resolved.

Chest Pain

Chest Pain Blood Pressure Ischemia STEMI

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. Supply-demand mismatch (non-occlusive coronary disease, or exacerbation of preexisting flow insufficiency) a.

Angina

Angina Ischemia Coronary Angiogram Stenosis

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

Case:A 74-year-old male with a recent NSTEMI presented for elective coronary artery revascularization. After placing temporary transvenous pacing and inserting sheaths in the right radial and right femoral arteries, both the RPL and RPD were wired with coronary guidewires.

Coronary Angiogram

Coronary Angiogram Stenosis Plaque Stents

Abstract 4142012: Ectasias of Multiple Coronary Arteries and a Coronary Cameral Fistula Between Right Coronary Artery and Coronary Sinus

Circulation

NOVEMBER 11, 2024

Coronary angiography revealed a tortuous and extremely aneurysmal RCA, as well as multivessel coronary artery disease (mvCAD) involving LAD, D1, LCx, OM1. Notably, the LAD had multiple aneurysmal segments and areas of eccentric stenosis upto 90%.Multislice

Coronary Artery Bypass Graft

Coronary Artery Bypass Graft ACE Inhibitor Coronary Angiogram Aneurysm

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

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

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. Oxygen supply is determined by: 1) oxygen carrying capacity, 2) O2 saturation, and 3) Coronary flow.

Ischemia

Ischemia Cardiogenic Shock Aortic Stenosis

A man with chest pain off and on for two days, and "No STEMI" at triage.

Dr. Smith's ECG Blog

JUNE 19, 2023

During angiogram in the cath lab, the patient suffered two episodes of ventricular fibrillation for which he was successfully defibrillated. Angiogram showed a culprit lesion of 100% stenosis to the right coronary artery and 100% stenosis of the right posterior descending artery, both with TIMI 0 flow.

Chest Pain

Chest Pain STEMI Cardiogenic Shock Ischemia

A woman in her 50s with chest pain and dyspnea

Dr. Smith's ECG Blog

MARCH 17, 2023

She had a prior history of "NSTEMI" one month ago, during which she had a coronary angiogram reportedly showing no stenosis in any coronary artery. Her vitals were within normal limits. Here is her triage ECG: PM Cardio Version (see original screenshot I received below) Original image.

Chest Pain

Chest Pain Coronary Angiogram Circulation Electrocardiogram

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

History sounds concerning for ACS (could be critical stenosis, triple vessel), but differential also includes dissection, GI bleed, etc. 2 cases of Aortic Stenosis: Diffuse Subendocardial Ischemia on the ECG. We investigated the incidence of an acutely occluded coronary in patients presenting with STE-aVR with multi-lead ST depression.

Ischemia

Ischemia STEMI Stenosis Chest Pain

Rise of the Lysenkoist Cardiologists

Dr. Anish Koka

MAY 16, 2023

Diamond and Forrester accomplished this by first establishing the prevalence of coronary artery disease based on how clinically likely patients with chest pain symptoms were found to have coronary disease based on a coronary angiogram. The results of this dataset by age and gender follow.

Chest Pain

Chest Pain Coronary Artery Disease Cancer Heart attacks

Hypertropic Cardiomyopathy: A Board Review Question Explained By Video

BoardVitals - Cardiovascular

MAY 1, 2017

On the other hand, the murmur in valvular aortic stenosis does not change substantially or decreases slightly following the Valsalva maneuver. A decrease in intensity, due to attenuation of obstruction, is heard after going from a standing to a sitting or squatting position, with a handgrip, and following passive elevation of the legs.

Cardiomyopathy

Cardiomyopathy Sudden Cardiac Death Bicuspid/Mitral Electrocardiogram

The Bleeding Heart

EMS 12-Lead

APRIL 21, 2022

Advanced multi-vessel disease was found with stents deployed to the mid-LCx (80% stenosis), D1 (90% stensosis), and the pLAD (95% stenosis). It’s judicious, then, to arrange for coronary angiogram. elevated BP), but rather directly correlated with coronary obstruction and stymied TIMI flow. Does the ECG normalize?

Ischemia

Ischemia Myocardial Infarction Blog Coronary Angiogram

Hypertrophic Cardiomyopathy

EMS 12-Lead

MAY 20, 2022

There is ventricular hypertrophy in the absence of abnormal loading conditions, such as aortic stenosis, or hypertension, for example – of which the most common variant is Asymmetric Septal Hypertrophy. Type II MI), however decided to pursue coronary angiogram out of an abundance of caution.

Cardiomyopathy

Cardiomyopathy Ischemia STEMI Coronary Angiogram

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 Electrophysiology Cardiomyopathy ICU

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

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

Reoperative minimal invasive off-pump coronary artery bypass graft in early left main stem stenosis following Modified Bentall procedure

Operator decision-making in angiography-only guided revascularization for lesions not indicated for FFR: a QFR-based functional assessment in chronic coronary syndrome

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

Critical Left Main

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

Abstract 4142012: Ectasias of Multiple Coronary Arteries and a Coronary Cameral Fistula Between Right Coronary Artery and Coronary Sinus

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

A man with chest pain off and on for two days, and "No STEMI" at triage.

A woman in her 50s with chest pain and dyspnea

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

Rise of the Lysenkoist Cardiologists

Hypertropic Cardiomyopathy: A Board Review Question Explained By Video

The Bleeding Heart

Hypertrophic Cardiomyopathy

What Lies Beneath

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