Circulation

NOVEMBER 11, 2024

Background:Myocardial infarction with nonobstructive coronary artery disease (MINOCA) is a special syndrome with clear evidence of myocardial ischemia, but no clear stenosis of coronary artery imaging sign. Circulation, Volume 150, Issue Suppl_1 , Page A4143007-A4143007, November 12, 2024.

Coronary Artery Disease 40

Coronary Artery Disease Atrial Fibrillation Myocardial Infarction Ischemia 40

DAIC

MARCH 6, 2024

milla1cf Wed, 03/06/2024 - 18:48 March 6, 2024 — Cleerly , the company on a mission to create a new standard of care to aid in the diagnosis of heart disease, has been granted Breakthrough Device Designation by the U.S. Food and Drug Administration ( FDA ) for its Coronary Artery Disease ( CAD ) Staging System.

Heart Disease 105

Heart Disease Heart attacks Heart Attack Technology 105

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.

Ischemia 40

Ischemia Cardiogenic Shock Aortic Stenosis 40

All About Cardiovascular System and Disorders

APRIL 21, 2024

Coronary angiography gives a visual impression about the severity of the stenosis. But it need not imply the actual functional significance of the stenosis in terms of flow physiology. indicates inducible ischemia while an FFR above 0.80 excludes ischemia in 90% of cases. Normal FFR is 1.0 and an FFR below 0.75

Myocardial Infarction 52

Myocardial Infarction Stents Stent Coronary Artery Disease 52

Dr. Smith's ECG Blog

NOVEMBER 15, 2023

Angiogram No obstructive epicardial coronary artery disease Cannot exclude non-ACS causes of troponin elevation including coronary vasospasm, stress cardiomyopathy, microvascular disease, etc. Detailed coronary artery evaluation not performed. This suggests further severe ischemia.

Coronary Angiogram 109

Coronary Angiogram Plaque Thrombosis STEMI 109

Dr. Smith's ECG Blog

DECEMBER 7, 2023

I quickly reviewed the patient’s records and saw that she was a 53 year old woman with a history of BMI 40, but no other identifiable risk factors for coronary artery disease. This proves effective treatment of the recurrent ischemia. The patient had no further symptoms of ischemia.

SCAD 124

SCAD Ischemia Coronary Artery Disease Cardiomyopathy 124

Dr. Smith's ECG Blog

OCTOBER 20, 2024

The first task when assessing a wide complex QRS for ischemia is to identify the end of the QRS. The ST segment changes are compatible with severe subendocardial ischemia which can be caused by type I MI from ACS or potentially from type II MI (non-obstructive coronary artery disease with supply/demand mismatch).

Cardiogenic Shock 128

Cardiogenic Shock Ischemia Chest Pain Cardiac Arrest 128

Dr. Smith's ECG Blog

JULY 21, 2024

After PCI — there was acceptable flow in the LM, LAD and LCx arteries. Angiography : LMCA — 90-99% osteal stenosis. LCx — 50-69% stenosis of the 1st marginal branch; with 100% distal LCx occlusion. There is no definite evidence of acute ischemia. (ie, Some residual ischemia in the infarct border might still be present.

Arrhythmia 131

Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 131

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

His response: “subendocardial ischemia. History sounds concerning for ACS (could be critical stenosis, triple vessel), but differential also includes dissection, GI bleed, etc. Smith : It should be noted that, in subendocardial ischemia, in contrast to OMI, absence of wall motion abnormality is common. Anything more on history?

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52

Coronary Artery Disease Journal

MARCH 7, 2024

Background Untreated multivessel disease (MVD) in acute myocardial infarction (AMI) has been linked to a higher risk of recurrent ischemia and death within one year. The immediate non-IRA PCI is associated with a significantly lower occurrence of unplanned ischemia-driven PCI (OR 0.60; confidence interval [CI] 0.44–0.83)

Myocardial Infarction 40

Myocardial Infarction Ischemia Thrombosis Stents 40

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.

Chest Pain 120

Chest Pain Blog Hospital Tachycardia 120

Dr. Smith's ECG Blog

AUGUST 9, 2019

Post by Smith and Meyers Sam Ghali ( [link] ) just asked me (Smith): "Steve, do left main coronary artery *occlusions* (actual ones with transmural ischemia) have ST Depression or ST Elevation in aVR?" Here I explain: First, you don't know for certain what the state of the artery was at the time of the ECG.

Myocardial Infarction 52

Myocardial Infarction Ischemia STEMI Cardiogenic Shock 52

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. This happens.

Chest Pain 52

Chest Pain Coronary Artery Disease Cancer Heart attacks 52

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. An apical OMI has the same ultrasound findings as takotsubo, and thus mimics takotsubo. Learning Points: 1.

Plaque 52

Plaque Chest Pain Thrombosis Stenosis 52

Dr. Smith's ECG Blog

MARCH 2, 2019

found that such ECG findings only represented left main ACS in 14% of such ECGs: Only 23% of patients with the aVR STE pattern had any LM disease (fewer if defined as 50% stenosis). Diffuse ST depression with ST elevation in aVR: Is this pattern specific for global ischemia due to left main coronary artery disease?

Sickle Cell Disease 52

Sickle Cell Disease Ischemia Dysrhythmia Chest Pain 52

Dr. Smith's ECG Blog

OCTOBER 6, 2018

The patient was in his 50s with history of hypertension, diabetes, seizure disorder, and smoking, but no known coronary artery disease. If the patient had been "lucky," his symptoms from the prior day might have been due to ischemia prolonged and intense enough to result in small troponin increase.

Chest Pain 40

Chest Pain STEMI Myocardial Infarction Coronary Artery Disease 40

Journal of the American Heart Association

FEBRUARY 27, 2024

Women had less coronary artery disease: multivessel in 60.0% of invasive‐assigned men, and no ≥50% stenosis in 12.3% 1.14];P=0.49), with no significant sex‐by‐treatment‐group interactions.ConclusionsWomen had less extensive coronary artery disease and, therefore, lower revascularization rates in the invasive group.

Ischemia 45

Ischemia Coronary Artery Disease Myocardial Infarction Outcomes 45

Dr. Smith's ECG Blog

DECEMBER 31, 2024

Written by Pendell Meyers A woman in her 70s with known prior coronary artery disease experienced acute chest pain and shortness of breath. One could argue or wonder if there is both subendocardial ischemia AND posterior OMI pattern, since the STD in V4 may be equal or possibly slightly worse proportionally than V6.

Ischemia 119

Ischemia Tachycardia Chest Pain STEMI 119

Frontiers in Cardiovascular Medicine

DECEMBER 15, 2024

BackgroundCoronary Artery Disease (CAD) is a leading cause of mortality, with an increasing number of patients affected by coronary artery stenosis each year. Coronary angiography (CAG) is commonly employed as the definitive diagnostic tool for identifying coronary artery stenosis.

Stenosis 52

Stenosis Coronary Artery Disease Ischemia Research 52

Dr. Smith's ECG Blog

MARCH 3, 2025

The patient was started on heparin for possible NSTEMI vs demand ischemia. Smith : "decompensation" of aortic stenosis might have initiated this entire cascade. What "initiates" the aortic stenosis cascade? increasing stenosis, ischemia, volume changes, increased blood pressure, atrial fibrillation, etc.)

Tachycardia 74

Tachycardia Pulmonary Chest Pain Stenosis 74

Dr. Smith's ECG Blog

DECEMBER 6, 2024

Watch what happends as the heart recovers from its episode of ischemia. Angiogram: Severe two-vessel coronary artery disease of a left dominant system including 70 to 80% stenosis involving the distal left main/bifurcation. The ECG shows inferior ischemia. Are the T-waves in leads I and II hyperacute?

Coronary Artery Bypass Graft 107

Coronary Artery Bypass Graft Ischemia Chest Pain Stenosis 107

Cardiometabolic Health Congress

JANUARY 2, 2025

August 2024 Approvals Minima Stent System (P240003) (Approval Date: August 28, 2024) The Minima Stent System is an expandable cobalt-chromium metal mesh tube to reopen blood vessels in neonates, infants, and children with Coarctation of the Aorta and Pulmonary Artery Stenosis, specifically designed to expand as younger patients grow.

Coronary Artery Disease 52

Coronary Artery Disease Stents Stent Innovation 52