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See how bad the outcome can be if you don't know OMI findings on the ECG, and don't use the Queen of Hearts

Dr. Smith's ECG Blog

The attending provider wrote “Agree with electrocardiogram interpretation”. An echocardiogram showed severely reduced global systolic function with an EF of 20-25% and an LV apical thrombus. All three lesions had TIMI 2 flow prior to stenting. An echocardiogram showed an EF of 20-25%. Normal EKG”. Normal ECG.

Outcomes 112
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Abstract 4140682: Clinical Case: Flipping the Script: Tackling CAD in Dextrocardia During Cardiac Catheterization

Circulation

Electrocardiogram (ECG) showed a prominent S wave in the left-sided leads and a prominent R wave in the right-sided chest leads, suggesting dextrocardia. After guidewire crossing, balloon angioplasty was performed, and a drug-eluting stent was deployed. His vital signs were normal, and the physical examination was unremarkable.

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What if your system adopted the recommendation that a computer "normal" ECG need not be shown to the doctor?

Dr. Smith's ECG Blog

Successful drug-eluting stent placement opening up 95% mid RCA stenosis to 0% residual Nonobstructive left system disease. Formal echocardiogram: Systolic function is at the lower limits of normal. Below the limit of detection. Left-ventriculogram showed severe infero-apical hypokinesis with LV ejection fraction 50 to 55%.

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Cardiac arrest: even after the angiogram, the diagnosis is not always clear

Dr. Smith's ECG Blog

It was stented. An echocardiogram on day 3 showed no wall motion abnormality (but of course, these can resolved with reperfusion, and the more time it has to resolve from "stunning", the more likely it is to be resolved). Updates on the Electrocardiogram in Acute Coronary Syndromes. The troponin I peaked at 8.1. References : 1.

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Precordial ST depression. What is the diagnosis?

Dr. Smith's ECG Blog

The OM-1 was opened and stented, then the LAD was stented 3 days later. Seventh , an immediate echocardiogram can make the distinction. The LAD had a 75% proximal lesion that by fractional flow reserve was hemodynamically significant. So there was 3-vessel disease, but with an acute posterior STEMI. At lease 0.5

STEMI 52
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Why we need continuous 12-lead ST segment monitoring in Wellens' syndrome

Dr. Smith's ECG Blog

It was stented. Here is the post PCI ECG: Minimal change Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 --Initial and 3 hours troponin I's were (ng/mL): 0.042, 0.054, 0.056, 0.040, 0.039, 0.037 --20 hour echocardiogram showed no wall motion abnormality. Eur Heart J 2000;21:1464–1472. Patel DJ, et al.

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This ECG was interpreted as completely NORMAL by the computer: What about it is THE critical finding??

Dr. Smith's ECG Blog

They were stented. Formal Echocardiogram: The estimated left ventricular ejection fraction is 58 %. Emergent cardiac outcomes in patients with normal electrocardiograms in the emergency department. The patient went to angiogram and was found to have two 99% LAD thromboses with TIMI-3 flow. The peak troponin was 1863 ng/L.