Dr. Smith's ECG Blog
DECEMBER 23, 2022
I immediately activated the critical care team and walked the patient to the critical care area, our "Stabilization Room." Acute MI due to plaque rupture does happen in young people, including young women. There are relatively large T-waves in V4-V6. Let's record another one." Beware a low HEART score.
Dr. Smith's ECG Blog
JUNE 23, 2024
Given the presentation, the cardiologist stented the vessel and the patient returned to the ICU for ongoing critical care. Lesions less than 70% are generally considered to be non-flow limiting. Two subsequent troponins were down trending. Echocardiogram showed LVEF 66% with normal wall motion and normal diastolic function.
DAIC
MARCH 25, 2024
Session 508) Battle of the Imagers - Jeopardy Edition! Session 509) Who Wants to Be a Millionaire in Eradicating Vascular Medicine Disparities? Clinical and Investigative Horizons The Clinical and Investigative Horizons is a new type of late-breaker session that was added for ACC23 and is back by popular demand.
Dr. Smith's ECG Blog
JANUARY 15, 2024
Colin is an emergency medicine resident beginning his critical care fellowship in the summer with a strong interest in the role of ECG in critical care and OMI. As an aside, the LCx OMI is a type 2 event, since it is due to supply-demand mismatch from thrombus, and not due to atherosclerotic plaque rupture or erosion).
Dr. Smith's ECG Blog
OCTOBER 7, 2019
The patient arrived at the Emergency Dept critical care area and had this ECG recorded: The sinus bradycardia persists. He was taken to the cath lab and underwent emergent intervention: Thrombotic stenosis of the proximal RCA (95% with evidence of plaque rupture) is the culprit for the patient's inferoposterior STEMI.
Dr. Smith's ECG Blog
DECEMBER 16, 2024
She had this ECG recorded: Obvious massive anterior STEMI She was quickly brought to the critical care area and the cath lab was activated. The blood pressure was 170/100 in the critical care area. This was ruptured plaque with thrombus. She has no SOB and no prior medical history. Her initial BP was 203/124.
Dr. Smith's ECG Blog
MARCH 8, 2025
In my review of the literature, there are many articles which purport to demonstrate an acutely increased risk of plaque rupture from emotional stress, but I could not find any credible case reports that were not at least as likely to be takotsubo. Mechanisms of plaque formation and rupture. Coronary plaque disruption.
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