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Quiz post: two patients with chest pain. Do either, both, or neither have OMI?

Dr. Smith's ECG Blog

Patient 2 A man in his 50s with history of CAD and prior PCI, diabetes, presented with acute constant chest pain for the past few hours. Triage ECG: It was interpreted as lateral STEMI, and he was sent to the cath lab, where the angiogram showed unchanged CAD from known prior, with no acute culprit. He was discharged home.

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The effect of gender on clinical outcomes following routine revascularizations with polymer-free sirolimus-eluting stents

Coronary Artery Disease Journal

The purpose of this report is to use propensity score matching to determine gender-specific differences in clinical outcomes after percutaneous coronary interventions with polymer-free sirolimus-coated stents. In the unmatched STEMI subgroup, all-cause mortality was significantly higher in females driven by older age (P < 0.001).

Stents 52
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Four anterior STEMIs: acute and reperfused vs. won't reperfuse, subacute and reperfused vs. not reperfused

Dr. Smith's ECG Blog

This 57 yo diabetic male presented with generalized fatigue, myalgias, and arthralgias , mild subjective fever and chills, and nausea. This 42 yo diabetic male presented with cough and foot pain. An open 90% LAD was stented. Preservation of R-wave may mean and initial Q-wave followed by an R-wave (this is called a QR-wave.

STEMI 52
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Management and outcomes of spontaneous coronary artery dissection: a systematic review of the literature

Frontiers in Cardiovascular Medicine

The overall prevalence of arterial hypertension was 33.2%, hyperlipidemia, 26.9%, smoking, 17.8%, and diabetes, 3.9%. with ST elevated myocardial infarction (STEMI), 3.41% with unstable angina, 0.56% with stable angina, and 0.11% were diagnosed with various types of arrhythmias. Approximately 48.5% and 1.3%, respectively.

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Early repol or anterior OMI?

Dr. Smith's ECG Blog

Written by Destiny Folk, MD, Adam Engberg, MD, and Vitaliy Belyshev MD A man in his early 60s with a past medical history of hypertension, type 2 diabetes, obesity, and hyperlipidemia presented to the emergency department for evaluation of chest pain. This ECG is highly concerning for LAD occlusion despite it not showing a STEMI criteria.

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Outcomes of PCI of all comers: the experience of a Kuwaiti independent healthcare institution

The British Journal of Cardiology

Intra-procedural data included access route, coronary anatomy, lesion complexity, number of stents deployed, door-to-balloon time for primary PCI, and any intra-procedural complications. and the average number of stents 2.6. The radial approach was used in 544/567 (95.94%), the average SYNTAX score was 34.8 ± 9.6,

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Chest Pain, ST Elevation, and an Elevated Troponin: Should we Activate the Cath Lab?

Dr. Smith's ECG Blog

These elevations meet STEMI criteria ( ≥ 1mm in 2 contiguous leads). While this may be change that is reciprocal to an Acute/Subacute Inferior STEMI, the problem is that LV aneurysm may also manifest with this reciprocal change. In STEMI, they are generally upright and large in proportion to the QRS. This case is tough.