Remove Echocardiogram Remove Ischemia Remove Physiology
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Diffuse Subendocardial Ischemia on the ECG. Left main? 3-vessel disease? No!

Dr. Smith's ECG Blog

A transthoracic echocardiogram showed an LV EF of less than 15%, critically severe aortic stenosis , severe LVH , and a small LV cavity. DISCUSSION: The 12-lead EKG EMS initially obtained for this patient showed severe ischemia, with profound "infero-lateral" ST depression and reciprocal ST elevation in lead aVR.

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What do heart tests tell us?

Dr. Sanjay Gupta

So today i wanted to talk to you about what each heart test tells us about these different aspects of heart disease Tests that tell you about the heart as a pump The most commonly used test to assess the heart as a pump is an echocardiogram. Overall though a normal cardiac MRI is even more reassuring than a normal echocardiogram.

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What happens when a patient with LAD OMI does not go immediately to the cath lab?

Dr. Smith's ECG Blog

Pain will resolve with completed infarct or with resolution of ischemia. ECG recorded at 7 hours All active ischemia is gone. Pain will resolve not just with resolution of ischemia, but with completion of infarction. This T wave progression sequence does not make physiologic sense. This looks like infarct completion.

STEMI 40
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A young patient with diminishing pain with a subtle but diagnostic ECG.

Dr. Smith's ECG Blog

Next day echocardiogram showed inferolateral hypokinesia with an EF of %45-50. On echocardiogram you will not see a "posterior" hypokinesia (will see "inferolateral") and, as in this case, LCx may not give the blood supply of basal inferior segment (formerly called "posterior"). The patient recovered well. J Am Heart Assoc. 121.022866.

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Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.

Dr. Smith's ECG Blog

Evidence of acute ischemia (may be subtle) vii. ST segment and T wave abnormalities consistent with or possibly related to myocardial ischemia. Fourth, syncope in the elderly often results from polypharmacy and abnormal physiologic responses to daily events. 2nd or 3rd degree AV blocks or sinus pause of at least 2 seconds iv.

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This ST segment is trying to confuse us

Dr. S. Venkatesan MD

The fact that the heart rate is normal rules out demand side ischemia as well. She needs an echocardiogram to rule out any subclinical myocardial disease. Echocardiogram is a must. Interpretation of T-wave inversion in physiological and pathological conditions: Current state and future perspectives. Reference 1.