Coronary Artery Disease Echocardiogram Ischemia 
Dr. Smith's ECG Blog
NOVEMBER 22, 2023
Important point: when there is diffuse subendocardial ischemia but no OMI, a wall motion abnormality will not necessarily be present. See this post: What do you think the echocardiogram shows in this case? They agreed ischemia was likely in the setting of demand given DKA and infection. 40 mg of furosemide was given.
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. A transthoracic echocardiogram showed an LV EF of less than 15%, critically severe aortic stenosis , severe LVH , and a small LV cavity.
Dr. Smith's ECG Blog
OCTOBER 12, 2024
CTA head and neck were obtained and showed no evidence of intracranial hemorrhage, large vessel occlusion stroke (what a helpful and apt name for an acute arterial occlusion paradigm, by the way.), or basilar ischemia. Preliminary findings documented in the cath lab were “Anterior STEMI and no significant coronary artery disease.” (!!!)
Dr. Smith's ECG Blog
NOVEMBER 4, 2022
His response: “subendocardial ischemia. Smith : It should be noted that, in subendocardial ischemia, in contrast to OMI, absence of wall motion abnormality is common. See this case: what do you think the echocardiogram shows in this case? Incidence of an acute coronary occlusion. Anything more on history?
Dr. Smith's ECG Blog
SEPTEMBER 25, 2024
A 56 year old male with a history of diabetes, dyslipidemia, hypertension, and coronary artery disease presented to the emergency department with sudden onset weakness, fatigue, lethargy, and confusion. The patient’s angiogram should have been expedited, but the EKG change was not recognized as recurrence of transmural ischemia.
Dr. Smith's ECG Blog
NOVEMBER 30, 2022
Hospital Course The patient was taken emergently to the cath lab which did not reveal any significant coronary artery disease, but she was noted to have reduced EF consistent with Takotsubo cardiomyopathy. Here is the cath report: Echocardiogram: There is severe hypokinesis of entire LV apex and apical segment of all the walls.
Dr. Smith's ECG Blog
SEPTEMBER 30, 2019
These findings are concerning for inferior wall ischemia with possible posterior wall involvement. He was taken emergently to the cardiac catheterization lab and found to have multi-vessel coronary artery disease with a near-occlusive culprit lesion in the RCA, possibly reperfused. No significant changes, ongoing pain.
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