EMS 12-Lead

AUGUST 25, 2024

Examples of cardio embolic stroke etiology include: 1. Atrial Fibrillation 2. Cardiomyopathy with mural thrombus 3. Patent Foramen Ovale 4. Severe calcific Aortic (valve) Stenosis 5. Mechanical prosthetic valve Severe carotid artery stenosis is also implicated in embolic stroke. Here is the admission ECG.

AFIB 59

AFIB Embolism Atrial Fibrillation RN 59

Circulation

NOVEMBER 11, 2024

Transthoracic echocardiogram (TTE) showed an ejection fraction (EF) of 40% and a moderate-large pericardial effusion with signs of tamponade. Intra-operative transesophageal echocardiogram (TEE) post-decannulation showed a normal EF without segmental abnormalities. Electrocardiogram (EKG) was unremarkable.

Myocardial Infarction 40

Myocardial Infarction Coronary Angiogram Echocardiogram Chest Pain 40

Circulation

NOVEMBER 11, 2024

Transthoracic echocardiogram revealed right to left shunting consistent with a patent foramen ovale (PFO). She was initiated on thrombolytic therapy and experienced resolution of symptoms.

Strokes 40

Strokes Stroke Aortic valve Myocardial Infarction 40

Circulation

NOVEMBER 11, 2024

A transthoracic echocardiogram (TTE) was ordered and showed a linear highly mobile mass in the right atrium that was intermittently protruding into the right ventricle and into the main pulmonary artery through the pulmonic valve. There was no visible evidence of tumor extension of the renal mass into the inferior vena cava.

Pulmonary 40

Pulmonary Echocardiogram Embolism Circulation 40

Journal of the American Heart Association

NOVEMBER 28, 2023

BackgroundComplex aortic plaque (CAP) is a potential embolic source in patients with cryptogenic stroke (CS). Journal of the American Heart Association, Volume 12, Issue 23 , December 5, 2023.

Plaque 40

Plaque Biomarkers Aortic Strokes 40

Dr. Smith's ECG Blog

DECEMBER 22, 2022

He visited an outpatient clinic for it and an echocardiogram and exercise stress test was normal. Bi-phasic scan showed no dissection or pulmonary embolism. In the meantime, cardiology consultant sees the patient and performs a bedside echocardiogram which revealed no major wall motion abnormalities.

STEMI 52

STEMI Chest Pain Myocardial Infarction Electrocardiogram 52

Dr. Smith's ECG Blog

DECEMBER 19, 2023

The commonest causes of MINOCA include: atherosclerotic causes such as plaque rupture or erosion with spontaneous thrombolysis, and non-atherosclerotic causes such as coronary vasospasm (sometimes called variant angina or Prinzmetal's angina), coronary embolism or thrombosis, possibly microvascular dysfunction.

Plaque 127

Plaque Angina Blog Stents 127

All About Cardiovascular System and Disorders

APRIL 30, 2024

Echocardiogram showing thickened interventricular septum and mitral regurgitation in HCM. Mid cavity obstruction in HCM is associated with apical aneurysm, systemic embolism, and arrhythmias. SAM in HCM Systolic anterior movement of mitral valve occurs in 30 – 60%, but it is not specific. Doppler echo showing LVOT gradient in HCM.

Cardiomyopathy 40

Cardiomyopathy Bicuspid/Mitral Document Arrhythmia 40

Dr. Smith's ECG Blog

JANUARY 15, 2024

While awaiting transfer to the cath lab, STAT echocardiogram was performed and showed LVEF 30-35%, as well as anterior, inferior, and apical hypokinesis, and apical thrombus. Then, part of the thrombus embolized into the LCx causing an inferoposterolateral OMI. (As This confirms the suspicion of prior anterior OMI.

Chest Pain 64

Chest Pain Blog Arrhythmia Critical Care 64

Dr. Smith's ECG Blog

DECEMBER 13, 2019

The next morning the patient went for his routine echocardiogram, where the operator noticed a dilated aortic root at 5.47 Patients with pulmonary embolism or aortic dissection who have normal variant ST elevation are at high risk of being diagnosed with pericarditis when what they have is far more serious!!

Pericarditis 52

Pericarditis Chest Pain Aortic Blog 52

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

Here is the cath report: Echocardiogram: There is severe hypokinesis of entire LV apex and apical segment of all the walls. Transient and partial thrombosis at the site of a non-obstructive plaque with subsequent spontaneous fibrinolysis and distal embolization may be one of the mechanisms responsible for the occurrence of MINOCA.

Plaque 52

Plaque Chest Pain Thrombosis Stenosis 52

Dr. Smith's ECG Blog

APRIL 8, 2015

Cardiac enzymes, CTs, echocardiograms, carotid ultrasounds, and electroencephalography all affected diagnosis or management in Postural blood pressure , performed in only 38% of episodes, had the highest yield with respect to affecting diagnosis (18-26%) or management (25-30%) and determining etiology of the syncopal episode (15-21%).

Arrhythmia 52

Arrhythmia Outcomes Risk Factors Chest Pain 52

Dr. Smith's ECG Blog

DECEMBER 6, 2024

Case continued Troponins over 26 hours, from right to left : Echocardiogram: Mild concentric left ventricular wall thickening, normal cavity size, and normal systolic function. By itself seeing this ECG pattern does not necessarily mean that the patient has a pulmonary embolism. The estimated left ventricular ejection fraction is 64%.

Coronary Artery Bypass Graft 107

Coronary Artery Bypass Graft Ischemia Chest Pain Stenosis 107

Dr. Smith's ECG Blog

FEBRUARY 16, 2025

Despite apparently hearing the above history together with two diagnostic ECGs and a troponin compatible with OMI, the cardiologist thought the ECG represented pericarditis and recommended echocardiogram. Echocardiogram was finally performed five hours after the first diagnostic ECG. This far out, the benefit of PCI is very attenuated.

STEMI 72

STEMI Pericarditis Chest Pain Echocardiogram 72