Dr. Smith's ECG Blog

JANUARY 5, 2024

The documentation does not describe any additional details of the history. They also documented "Reproducible chest tenderness." On the combined basis of angiography and IVUS, this patient received stents to his mid RCA, proximal PDA, and OM. RCA and PDA before and after, arrows indicating stented regions.

Angina 120

Angina Plaque Document Stents 120

DAIC

JANUARY 9, 2024

Secemsky, MD, MSc, FSCAI , lead author of the proceedings document and Director of Vascular Intervention, Beth Israel Deaconess Medical Center. During the roundtable, participants highlighted the potential of IVUS in guiding revascularization procedures, such as angioplasty and stenting, to optimize outcomes for patients.

Peripheral Arterial Disease 105

Peripheral Arterial Disease Ultrasound Angioplasty Interventional Cardiology 105

Frontiers in Cardiovascular Medicine

FEBRUARY 26, 2024

No-Touch” harvesting techniques, specific storage solutions, pressure controlled graft flushing and external stenting are important and established methods aiming to overcome the process of intimal hyperplasia at different time levels. Still despite the known evidence these methods are not standard everywhere.

Coronary Artery Bypass Graft 59

Coronary Artery Bypass Graft Pharmacology Document Stents 59

Open Heart

JANUARY 19, 2023

Bleeding events were defined as any bleeding based on the Valve Academic Research Consortium-2 consensus document at 1 year. Patterns of Non-adherence to Anti-Platelet Regimen in Stented Patients (PARIS) and Coronary Revascularisation Demonstrating Outcome Study in Kyoto (CREDO-Kyoto) integer scoring systems were tested.

Aortic valve 52

Aortic valve TAVR Aortic Myocardial Infarction 52

Frontiers in Cardiovascular Medicine

DECEMBER 13, 2024

CiteSpace (version 6.2.1), RStudio and VOSviewer (version 1.6.18) were used for visual analysis of regional distribution, institutions, authors, keywords and other information.ResultsThe number of documents on abdominal aortic aneurysm research increased continuously and has stabilized in recent years.

Aneurysm 52

Aneurysm Aortic Research Download 52

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Vertebral artery web has limited scientific documentation throughout the literature. first reported 3 patients with vertebral webs diagnosed by DSA and having MRI show ischemic strokes in the vascular territory were treated with endovascular stenting and had no recurrence of an ischemic event (4). Pereira et al. Lenck et al.

Stroke 40

Stroke Strokes Stents Stent 40

Dr. Smith's ECG Blog

DECEMBER 27, 2023

Cardiology consult note written around that time documents that "Pain improved with NTG, morphine in ED but still present." Just before 10 AM, the patient received a stent to the culprit OM. We know that today's patient has had prior inferior OMI with stenting of his proximal RCA ~3 years earlier. Peak troponin was 12 ng/mL.

Chest Pain 130

Chest Pain Myocardial Infarction Blog Stents 130

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Primary outcomes were functional status recorded as modified Rankin scores (mRS) and radiographic occlusion rates documented as Raymond‐Roy scores.

Aneurysm 40

Aneurysm Embolism Stents Stent 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Adequate occlusion was documented at 97.8% (WOS) and 93.3% (OSC). An analysis of the data shows that larger aneurysm dimensions, necessity for adjunctive stent, and minor compaction were significantly associated with inadequate occlusion. The median maximal aneurysm diameter was 6.9mm, while the median neck size was 4.4mm.

Aneurysm 40

Aneurysm Embolism Hemorrhage Document 40

All About Cardiovascular System and Disorders

JANUARY 14, 2024

Magnetic resonance imaging is another way of documenting coronary anomalies. Stenting of the patent ductus arteriosus can be considered in neonatal period for improving oxygen saturation till corrective surgery. Finding out the origin and insertion of MAPCAs is important prior to surgical repair of tetralogy of Fallot.

Congenital Heart Disease 52

Congenital Heart Disease Pulmonary Anatomy Congenital 52

Dr. Smith's ECG Blog

SEPTEMBER 9, 2024

The operator documented thoughtful consideration of risks and benefits of stent placement. Technically, there was a very narrow landing zone for the stent, and missing this could result in "jailing" the LCx, which is ideally avoided. At the time of IVUS, there was no thrombus. Repeat hsTnI just after cath was 36,029 ng/L.

Plaque 66

Plaque Stents Stent Chest Pain 66

Dr. Smith's ECG Blog

JULY 3, 2018

Submitted and written by Alex Bracey with edits by Pendell Meyers and Steve Smith Case A 50ish year old man with a history of CAD w/ prior LAD MI s/p LAD stenting presented to the ED with chest pain similar to his prior MI, but worse. The patient underwent successful placement of one drug eluting stent with restoration of TIMI 3 flow.

Pericarditis 52

Pericarditis Chest Pain Stents Stent 52

Dr. Smith's ECG Blog

MARCH 22, 2024

This is documented as a STEMI in the clinical notes and in the cath report, but certainly does not meet STEMI criteria and is therefore an NSTEMI by definition. And because swirl is a sign of LAD OMI, it is not surprising that there is reciprocal depression inferiorly in II. This was the cost of preventing infarction of the anterior wall.)

Chest Pain 114

Chest Pain STEMI Bradycardia Ischemia 114

Dr. Smith's ECG Blog

NOVEMBER 15, 2013

It is well documented with continuous 12-lead monitoring that acute re-occlusion is frequently asymptomatic. It was stented. Here is the most recent documentation that T-wave inversion does indicate reperfusion: [link] 6. New ST elevation diagnostic of STEMI [equation value = 25.3 Heart 1996;75:222–228. de Wood et al.

Chest Pain 52

Chest Pain Thrombosis Myocardial Infarction STEMI 52

Dr. Smith's ECG Blog

JUNE 28, 2019

60-something with h/o MI and stents presented with chest pain radiating to the back and nausea/vomiting. It was stented. The patient had a p rior h istory of MI + stents. In this patient with documented coronary disease — these q waves could reflect prior lateral infarction ( especially in view of the Q in lead aVL ).

Chest Pain 52

Chest Pain Pericarditis Stents Stent 52

Dr. Smith's ECG Blog

MARCH 27, 2025

Nurse notes: the silent scream of the heart The emergency nursing notes document the patient complaining of chest pain refractory to nitro, with a rising trop: 2200: ECG shown to ED MD 0020: repeat ECG shown to ED MD, patient complain of midsternal chest pain 0520: nitro x 3. The total occlusion was recanalized and stented from 100 to 0%.

STEMI 80

STEMI Chest Pain Pericarditis Ischemia 80

Dr. Smith's ECG Blog

APRIL 14, 2023

Sent by Anonymous, written by Pendell Meyers A man in his 60s with history of CAD and 2 prior stents presented to the ED complaining of acute heavy substernal chest pain that began while eating breakfast about an hour ago, and had been persistent since then, despite EMS administering aspirin and nitroglycerin. Pre-intervention.

Chest Pain 52

Chest Pain STEMI Stents Stent 52

Dr. Smith's ECG Blog

JANUARY 9, 2024

The patient is female in her 80s with a medical hx of previous MI with PCI and stent placement. She also has a hx of paroxysmal atrial fibrillation and is on oral anticoagulant treatment. She had a single chamber ICD/Pacemaker implanted several years prior due to ventricular tachycardia. The last echocardiography 12 months ago showed HFmrEF.

Tachycardia 119

Tachycardia Electrophysiology Atrial Flutter Ischemia 119

Dr. Smith's ECG Blog

DECEMBER 29, 2023

Angiogram found a totally occluded first diagonal artery, consistent with all the ECGs, which reperfused after stenting. Eur Heart J Dig Health 2023 == MY Comment , by K EN G RAUER, MD ( 12/27 /2023 ): == Superbly documented case by Dr. McLaren — in which the unfortunate details of opportunities missed are sequentially recounted.

Chest Pain 70

Chest Pain STEMI Myocardial Infarction Electrocardiogram 70

Dr. Smith's ECG Blog

NOVEMBER 26, 2015

We can see that there is evolution of the elevations, worsening reciprocal change, as well as evolution of posterior involvement (right precordial R-waves with ST depression) There was very little documentation surrounding these ECGs. She received PCI with 2 drug-eluting stents in overlying fashion. She had a very large troponin leak.

Chest Pain 52

Chest Pain Aneurysm STEMI Document 52

Dr. Smith's ECG Blog

JULY 11, 2018

He did, found the true culprit, and went back in to stent it. His astute observation is worthy of brief discussion: Rituparna et al document a case study report, in which J waves appeared to be induced by ischemia ( Pacing Clin Electrophysiol 30(6):817-819, 2007 ). You can listen to my explanation by playing the video.

Chest Pain 52

Chest Pain STEMI Ischemia Blog 52

Dr. Smith's ECG Blog

DECEMBER 23, 2022

Opened and stented. Especially if there are ongoing symptoms ( and especially if there is a change in the severity of these symptoms ) — repeating the ECG ( sometimes as soon as 5-10 minutes later ) may demonstrate a change in ECG findings that documents “ dynamic ” ST-T wave change.

Chest Pain 52

Chest Pain Critical Care STEMI Plaque 52

Dr. Smith's ECG Blog

NOVEMBER 13, 2022

The lesion was successfully stented, but it was unfortunately done after a significant myocardial loss. ST elevation in both anterior and inferior leads does not necessarily indicate an LAD "wraparound" lesion ( Bozbeyoğlu reference documenting this cited by Dr. Aslanger below — with Dr. Aslanger as one of the co-authors ).

Chest Pain 52

Chest Pain Myocardial Infarction Blog Pericarditis 52

Dr. Smith's ECG Blog

MARCH 19, 2023

It was opened and stented. To realize — Assessment of ECG #1 is complicated by knowing: i ) That today’s patient has a history of documented CAD ; and , ii ) The lack o f a prior tracing for comparison at the time the initial ECG was interpreted. Formal bubble contrast echo: The estimated left ventricular ejection fraction 57%.

Chest Pain 52

Chest Pain STEMI Myocardial Infarction Document 52

Dr. Smith's ECG Blog

JULY 19, 2019

This prompted a repeat ECG (we do not have documentation from that time to tell us whether he had persistent, recurrent, or absent pain): Progression of anterior OMI to full Q-wave MI with large pathologic Q-waves in V2-V4 with persistent STE which now meets STEMI criteria (after full thickness infarction/stunning). ng/mL (very elevated).

Chest Pain 52

Chest Pain STEMI Aneurysm Pericarditis 52

DAIC

APRIL 23, 2024

2 Based on internal document D00437207, Avalus Ultra Design Concept. Surgical aortic valve replacement with a stented pericardial bioprosthesis: 5-year outcomes. 8 Based on internal document D00437207, Avalus Ultra Design Concept 9 Klautz RJM, Dagenais F, Reardon MJ, Lange R, Moront MG, Labrousse L et al. February 18–21, 2024.

Aortic valve 111

Aortic valve Aortic Innovation Cardiothoracic 111

DAIC

JUNE 13, 2024

2 Based on internal document D00437207, Avalus Ultra Design Concept. Surgical aortic valve replacement with a stented pericardial bioprosthesis: 5-year outcomes. 8 Based on internal document D00437207, Avalus Ultra Design Concept 9 Klautz RJM, Dagenais F, Reardon MJ, Lange R, Moront MG, Labrousse L et al. February 18–21, 2024.

Aortic valve 109

Aortic valve Aortic Innovation Cardiothoracic 109

DAIC

JUNE 28, 2024

With calcification in blood vessels, a stent can help, but you can’t do that with the aortic valve. Heart disease is the leading killer annually — about 18 million deaths per year — and that number is growing. A large proportion is the result of calcification,” said study leader Bruce Fouke , a U.

Aortic valve 105

Aortic valve Aortic Document Research 105

Dr. Smith's ECG Blog

SEPTEMBER 19, 2023

Past medical history includes coronary stenting 17 years prior. If you take old people with a history of MI (he had a stent), that percentage goes far higher since there is scar tissue that acts as a nidus for the PVCs that initiate VT. He had concurrent sharp substernal chest pain that resolved, but palpitations continued.

Tachycardia 138

Tachycardia Cardiogenic Shock Angina Coronary Angiogram 138

Dr. Anish Koka

JULY 23, 2023

An expert hired by the state medical board reviewed 8 cases and concluded the practice was characterized by overtreatment and poor documentation. Dormu, who on the same day, performs another angiogram which revealed an in-stent restenosis of the superficial femoral artery stent and a 60% stenosis of the tibioperoneal trunk.

Vascular Care 52

Vascular Care Outpatient Peripheral Arterial Disease Stents 52

Dr. Smith's ECG Blog

MAY 13, 2024

The culprit mid LAD lesion was stented. Several hours later, angiogram showed: Culprit lesion mid LAD, 75% stenosis, TIMI 3, thrombotic, likely the source of the distal LAD 100% embolic occlusion, with TIMI 0 flow. It is not clear in the report whether thrombectomy was performed on the distal LAD occlusion.

Chest Pain 120

Chest Pain STEMI Ultrasound Heart Attack 120

Dr. Smith's ECG Blog

DECEMBER 11, 2023

Triage documented a complaint of left shoulder pain. Here is the angiogram after stent placement. The neighbor recorded a systolic blood pressure again above 200 mm Hg and advised her to come to the ED to address her symptoms. The patient presented to triage at around 10 PM. The patient said, "I just don't feel good."

Myocardial Infarction 123

Myocardial Infarction Chest Pain STEMI Blood Pressure 123

Dr. Smith's ECG Blog

OCTOBER 2, 2021

We assume that at some point the patient's pain returned, but it is not documented, so exactly when this happened is uncertain. He was successfully treated with one drug eluting stent.

Chest Pain 52

Chest Pain Ultrasound STEMI Myocardial Infarction 52

Dr. Paddy Barrett

AUGUST 1, 2023

This is where careful discussion with the patient is required, and an explanation of the most recent literature suggests no reduction in future major heart events with stenting in most obstructive coronary artery disease 5. ( 3 ESC Scientific Document Group. But that’s a whole can of worms for another day). Medicine (Baltimore).

Coronary Angiogram 52

Coronary Angiogram Plaque Coronary Artery Disease Chest Pain 52

Dr. Smith's ECG Blog

APRIL 8, 2016

This was stented. Document in the patient's chart that rapid infusion is intentional in response to life-threatening hypokalemia." After pacing, there was no recurrence of Torsades. After resuscitation, he was found to have a 90% thrombotic lesion in the same saphenous vein graft to the right posterior descending artery.

STEMI 52

STEMI Myocardial Infarction Cardiac Arrest Arrhythmia 52

Dr. Smith's ECG Blog

DECEMBER 27, 2024

Submitted anonymously, written by Willy Frick A man in his 70s with a history of remote MI (details unavailable) and prior stent placement presented to cardiology clinic for routine follow up. Documentation lists a diagnosis of "sinus tachycardia." He complained of days to weeks of palpitations and dyspnea. His clinic ECG is shown.

Tachycardia 121

Tachycardia Stents Stent Arrhythmia 121

Dr. Smith's ECG Blog

MARCH 25, 2025

Documentation indicates that the patient was shocked 4 times (with no comment on energy level) and received amiodarone 300 mg IV and magnesium 2 g IV. And in a study like COMPLETE or MULTISTARS AMI, you are stenting an acute plaque rupture (the culprit) and non-ruptured, non-culprit and hence essentially stable plaques.

Chest Pain 63

Chest Pain Ischemia Plaque Stents 63