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 52

Angina Ischemia Coronary Angiogram Stenosis 52

Dr. Smith's ECG Blog

MAY 16, 2023

Sent by Dan Singer MD, written by Meyers, edits by Smith A man in his late 30s presented with acute chest pain and normal vitals except tachycardia at about 115 bpm. As Ken says below, tachycardia is not common in OMI and distorts the ST segment, so managing the tachycardia and repeating the ECG is a good strategy.

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Chest Pain Pericarditis Tachycardia STEMI 52

EMS 12-Lead

AUGUST 22, 2022

From afar, there is gross tachycardia, cadence irregularities, and narrow QRS complexes that may, or may not, be Sinus in origin; and finally – a cacophony of wide complexes that might very well be ventricular in origin. McLaren : We’ve answered the first question – Sinus Tachycardia with episodic runs of wide QRS (RBBB morphology) and PVC’s.

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Tachycardia Electrophysiology Cardiomyopathy ICU 52

EMS 12-Lead

MARCH 19, 2023

The shortened PR-interval, specifically, proved to be quite beguiling as it swept crews down a differential diagnosis of intermittent accessory pathway syndrome – insomuch as a “syndrome” of recurrent tachycardia to account for the patient’s symptoms. Learning points 1] Acute Coronary Syndrome has many shades of clinical manifestation.

Myocardial Infarction 52

Myocardial Infarction STEMI Coronary Angiogram Coronary Artery Disease 52

Dr. Smith's ECG Blog

SEPTEMBER 16, 2024

A coronary angiogram was done that did not show significant coronary artery disease. But there are 3 other wide beats in the tachycardia that begins with beat #6 ( = beats #7; 13,14 ). Post ROSC the patient was alert and cooperative. Echocardiography showed apical ballooning with hypokinesis.

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Cardiac Arrest Cardiomyopathy Arrhythmia Atrial Fibrillation 69

Dr. Smith's ECG Blog

MAY 19, 2022

Ct coronary angiogram showed normal coronary arteries. Smith note: I think CT coronary angiogram is reasonable with the elevated troponins and symptoms. T-wave inversions and dynamic ST elevation Tachycardia, hyperthyroid, and ST elevation. He was diagnosed with mild AKI which resolved. What is it?

Chest Pain 52

Chest Pain Exercise Pacemaker Coronary Angiogram 52

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. A slightly prolonged QTc ( although this is difficult to assess given the tachycardia ).

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52

EMS 12-Lead

APRIL 21, 2022

There is appreciable STE aVR with near-global STD that appropriately maximizes in Leads II and V5, and thus suggesting a circumstance of generic, diffusely populated, circumferential subendocardial ischemia versus occlusive coronary thrombus. [1] It’s judicious, then, to arrange for coronary angiogram. Does the ECG normalize?

Ischemia 52

Ischemia Myocardial Infarction Blog Coronary Angiogram 52

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. 3) Anemia, or poisons of hemoglobin such as methemoglobin or CO 4) Fixed coronary stenosis that limits flow.

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Ischemia Cardiogenic Shock Aortic Stenosis 40

Dr. Smith's ECG Blog

MARCH 3, 2025

The status of the patients chest pain at this time is unknown : EKG 1, 1300: There is sinus tachycardia and artifact of low and high frequency. However, there is also significant tachycardia , with heart rate of 116, and known hypoxia. Acute coronary occlusion and acute pulmonary edema can coexist.

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Tachycardia Pulmonary Chest Pain Stenosis 74

Dr. Smith's ECG Blog

FEBRUARY 6, 2025

During observation in the ED the patient had multiple self-terminating runs of Non-Sustained monomorphic Ventricular Tachycardia (NSVT). CT coronary angiogram showed a hypoplastic RCA and dominant LCx. This patient very likely has some form of idiopathic ventricular tachycardia. No PVCs are seen.

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Tachycardia Arrhythmia Atrial Flutter Ablation 73

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. It was not SCAD (coronary dissection) Highest troponin I was 37,000 ng/L, but it was not measured to peak.

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Chest Pain Aortic STEMI Ultrasound 105

Dr. S. Venkatesan MD

JANUARY 22, 2025

One big chunk of ACS-UA is secondary UA where there is increased demand as in stable angina with tachycardia*. 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.

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Coronary Angiogram Chest Pain Anatomy Angina 52