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Intervention for critical aortic stenosis in Hutchinson-Gilford progeria syndrome

Frontiers in Cardiovascular Medicine

With this longer lifespan, calcific aortic stenosis (AS) was identified as an emerging critical risk factor for cardiac death in older patients. Intervention to relieve critical AS has the potential for immediate improvement in healthspan and lifespan. years by 4.3 years (30%).

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Edwards Acquires JenaValve and Endotronix, Expands into Aortic Regurgitation and Heart Failure

CardiacWire

These two acquisitions could impact Edwards’ structural heart and heart failure portfolios in unique and meaningful ways… JenaValve’s Trilogy TAVR system doesn’t yet have FDA approval, but is CE Marked for both aortic regurgitation and aortic stenosis, which is notable given that all other TAVR systems only address aortic stenosis.

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Epigastric and Right Upper Quadrant pain after eating spicy food

Dr. Smith's ECG Blog

It turns out that the conventional algorithm was also worried, and because of that, the patient was brought to the critical care area. The STE in V1 is out of proportion to the S-wave, so V1 is also very worrisome (something I did not see on my phone). So we don't have a good idea how large the final infarct size was.

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An elderly male with shortness of breath

Dr. Smith's ECG Blog

Angiogram --LAD is a large-caliber vessel that wraps around the apex --There is a tubular 80% in the ostial LAD that was relatively smooth but did not resolve with repeated doses of IC nitroglycerin --There is a tiny D1, medium D2, and small D3 Lesion on Prox LAD: Ostial 80% stenosis. Pre- procedure TIMI III flow was noted.

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A 50-something with acute chest pain, a computer "Normal" ECG, and a HEART score of 3 (low risk)

Dr. Smith's ECG Blog

Another very astute faculty physician immediately recognized that the ECG is diagnostic of posterior and lateral OMI , and activated the cath lab. The cardiology fellow came to the ED. Supplies a very large OM1.

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What do you think of this ECG?? Is this during pain, or after pain resolution? Also, see the CT image of the heart.

Dr. Smith's ECG Blog

There was high suspicion of OMI, so patient was brought to critical care area and another ECG was recorded just 7 minutes later as the pain had diminished to 4/10. Left main: no significant stenosis. LAD: proximal 60% eccentric stenosis the hemodynamic significance of which is indeterminate.

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Noisy, low amplitude ECG in a patient with chest pain

Dr. Smith's ECG Blog

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. Written by Colin Jenkins. Edits by Willy Frick. This suggests thrombus (since the contrast does not penetrate the formed thrombus very well).