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 126

Plaque Angina Blog Stents 126

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. To prove there is no plaque rupture, you need to do intravascular ultrasound (IVUS). An angiogram is a "lumenogram;" most plaque is EXTRALUMINAL!! ng/mL by 4th generation and older assays.)

Plaque 52

Plaque Chest Pain Thrombosis Stenosis 52

Dr. Smith's ECG Blog

SEPTEMBER 9, 2024

The patient was thought to have low likelihood of ACS, and cardiology recommended repeat troponin, urine drug testing, and echocardiogram. Bedside echocardiogram showed hypokinesis of the mid to distal anterior wall and apex. Smith comment : a very high proportion of MINOCA are ruptured plaque with lysed thrombus.

Plaque 65

Plaque Stents Stent Chest Pain 65

EMS 12-Lead

JULY 24, 2023

Category 1 : Sudden narrowing of a coronary artery due to ACS (plaque rupture with thrombosis and/or downstream showering of platelet-fibrin aggregates. elevated BP), but rather directly correlated with coronary obstruction (due to plaque rupture and thrombosis) and, potentially, stymied TIMI flow. Severe Hypoxia b.

Angina 52

Angina Ischemia Coronary Angiogram Stenosis 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

See this case: what do you think the echocardiogram shows in this case? Widespread ST-depression with reciprocal aVR ST-elevation can be cause by: Heart rate related: tachyarrhythmia (e.g., POCUS showed good LV-function and no pericardial effusion. The patient had mild but diffuse abdominal tenderness.

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52

Dr. Smith's ECG Blog

JANUARY 21, 2025

In this study of consecutive patients with LBBB who were hospitalized and had an echocardiogram, a QRS duration less than 170 ms (n = 262), vs. greater than 170 ms (n = 38), was associated with a significantly better ejection fraction (36% vs. 24%). So indeed the QRS is approximately 200 ms. Comment: What is the normal QRS duration in LBBB?

Chest Pain 61

Chest Pain STEMI Tachycardia Myocardial Infarction 61