Remove Dysrhythmia Remove Ischemia Remove Stent
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An athletic 30-something woman with acute substernal chest pressure

Dr. Smith's ECG Blog

Now you have ECG and troponin evidence of ischemia, AND ventricular dysrhythmia, which means this is NOT a stable ACS. The lesion was stented. It they are static, then they are not due to ischemia. This is better evidence for ischemia than any other data point. Again, cath lab was not activated.

SCAD 52
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STEMI with Life-Threatening Hypokalemia and Incessant Torsades de Pointes

Dr. Smith's ECG Blog

This was stented. If there is polymorphic VT with a long QT on the baseline ECG, then generally we call that Torsades, but Non-Torsades Polymorphic VT can result from ischemia alone. Could the dysrhythmias have been prevented? After pacing, there was no recurrence of Torsades. The patient stabilized. mEq/L: The STE is resolved.

STEMI 52
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Unresponsive and Acidotic: OMI? Acute, subacute, or reperfused? What is the rhythm? Why RV dysfunction? Can CT scan help?

Dr. Smith's ECG Blog

There is Transmural ischemia of Occlusion MI. Spectral CT This spectral CT image really highlights the dense transmural ischemia of the posterior wall. Here you can also see that there is dense ischemia of the RV. But I'm not sure how to explain the RV ischemia based on either ECG or angiogram.