Dr. Smith's ECG Blog

MARCH 6, 2023

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.

Chest Pain 52

Chest Pain STEMI Stenosis Blog 52

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

Chest Pain 64

Chest Pain Blog Arrhythmia Critical Care 64

Dr. Smith's ECG Blog

JULY 16, 2022

A 3rd troponin returned before the angiogram was done and was 2956 ng/L Here is the angiogram description: The distal RCA has mild diffuse disease and bifurcates to give a large RPDA which is without significant stenosis. Plus he did a 2 year combined EM Cardiology and Critical Care Fellowship.

Chest Pain 52

Chest Pain Bradycardia Blog Critical Care 52

Dr. Smith's ECG Blog

NOVEMBER 1, 2022

This EKG was recorded as part of a standing order for critical care. He had been smoking an opiate and suddenly collapsed. He was ventilated with BVM on arrival. He awoke with naloxone. He denied any CP or SOB. An EKG was repeated at 5 minutes The T-wave is less hyperacute. Maybe there is some spontaneous reperfusion?

Chest Pain 52

Chest Pain Coronary Artery Bypass Graft Pericarditis Blog 52

Dr. Smith's ECG Blog

FEBRUARY 12, 2023

Later, I was working in the ED and a patient was moved from a regular room to the critical care area due to recurrent hypotension. The patient was now under my care. That condition is tricuspid stenosis, which is rare. So I thought it probably is not posterior OMI and I just moved on and kept reading EKGs.

Pulmonary 40

Pulmonary Chest Pain Hypertension Tricuspid 40

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.

Bradycardia 40

Bradycardia Cardiogenic Shock STEMI Ischemia 40

Dr. Smith's ECG Blog

OCTOBER 6, 2018

We brought the patient into one of our critical care rooms and immediately got more history while recording this repeat ECG: The STE in I has greatly diminished or entirely disappeared. Let's zoom in on I and aVL: Lead I (top panel) has less than 1mm of STE. aVL is also less dramatic but still abnormal.

Chest Pain 40

Chest Pain STEMI Myocardial Infarction Coronary Artery Disease 40

Society of Thoracic Surgeons - Research

APRIL 20, 2023

Adult Cardiac Surgery Database Lead Author Title Publication Date Jacob Raphael Red Blood Cell Transfusion and Pulmonary Complications: The Society of Thoracic Surgeons Adult Cardiac Surgery Database Analysis The Annals of Thoracic Surgery January 2024 Joseph Sabik Multi-Arterial versus Single-Arterial Coronary Surgery: Ten Year Follow-up of One Million (..)

Research 52

Research Coronary Artery Bypass Graft Aortic valve Congenital 52

Society of Thoracic Surgeons - Research

APRIL 20, 2023

Mark Erfe 2 Outcomes of Sutureless/Rapid Deployment Valves Compared to Traditional Bioprosthetic Aortic Valves The Annals of Thoracic Surgery September 2020 Victor Nauffal 2 Short-Term Outcomes of Transcatheter Versus Isolated Surgical Aortic Valve Replacement for Mediastinal Radiation-Associated Severe Aortic Stenosis Circulation: Cardiovascular Interventions (..)

Research 52

Research Coronary Artery Bypass Graft Aortic valve Congenital 52