Dr. Smith's ECG Blog

DECEMBER 19, 2023

link] A 62 year old man with a history of hypertension, type 2 diabetes mellitus, and carotid artery stenosis called 911 at 9:30 in the morning with complaint of chest pain. His echocardiogram showed normal wall motion. This is written by Willy Frick, an amazing cardiology fellow in St. Before and after of the LAD shown below.

Plaque 127

Plaque Angina Blog Stent 127

Dr. Smith's ECG Blog

SEPTEMBER 25, 2024

EKG initially negative but repeat shows a few T wave abnormalities… There is a chance this could be non-cardiac pain” At 1518, an echocardiogram showed normal LV size and systolic function with hypokinesis of the mid and distal anterior wall and the mid and distal septum. RAO Caudal view: This is the RAO Caudal view.

Chest Pain 120

Chest Pain Blog Hospital Tachycardia 120

Dr. Smith's ECG Blog

MARCH 9, 2013

A stent was placed. For those who depend on echocardiogram to confirm the ECG findings of ischemia, this should be sobering. Characteristic electrocardiographic pattern indicating a critical stenosis high in left anterior descending coronary artery in patients admitted because of impending myocardial infarction. de Zwaan C.,

Chest Pain 52

Chest Pain Myocardial Infarction Ischemia Angina 52

Dr. Smith's ECG Blog

JUNE 19, 2023

Angiogram showed a culprit lesion of 100% stenosis to the right coronary artery and 100% stenosis of the right posterior descending artery, both with TIMI 0 flow. Two stents were placed with resultant TIMI 3 flow.

Chest Pain 52

Chest Pain STEMI Cardiogenic Shock Bradycardia 52

Dr. Smith's ECG Blog

JANUARY 28, 2023

hours after that first diagnostic ECG) : Mid-LAD culprit lesion, 99% stenosis, no pre-intervention TIMI flow available, but described as "severe subtotal lesion", which was stented with reported TIMI 3 flow resulting. Another lesion in the proximal LAD with 80% stenosis was stented as well. Angiogram @ 1830 (3.3

STEMI 52

STEMI Chest Pain Stent Stents 52

Dr. Smith's ECG Blog

OCTOBER 28, 2013

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). Here is the post cath ECG T-wave inversions consistent with anterior MI, but not diagnostic.

Cardiac Arrest 52

Cardiac Arrest Ischemia Defibrillator Electrocardiogram 52

Dr. Smith's ECG Blog

JULY 3, 2018

Submitted and written by Alex Bracey with edits by Pendell Meyers and Steve Smith Case A 50ish year old man with a history of CAD w/ prior LAD MI s/p LAD stenting presented to the ED with chest pain similar to his prior MI, but worse. The patient underwent successful placement of one drug eluting stent with restoration of TIMI 3 flow.

Pericarditis 52

Pericarditis Chest Pain Stent Stents 52

Dr. Smith's ECG Blog

JULY 16, 2022

This middle aged male with h/o GERD but also h/o stents presented to the ED with chest pain. A 3rd troponin returned before the angiogram was done and was 2956 ng/L Here is the angiogram description: The distal RCA has mild diffuse disease and bifurcates to give a large RPDA which is without significant stenosis.

Chest Pain 52

Chest Pain Bradycardia Blog Critical Care 52

Dr. Smith's ECG Blog

NOVEMBER 1, 2022

The 50-something patient with history of coronary stenting and slightly reduced LV ejection fraction. In the setting of prior stenting and reduced left ventricular ejection fraction, would pursue a heart team revascularization approach Syntax score 28.5, This alone could be due to LVH, but V4 could NOT be due to LVH.

Chest Pain 52

Chest Pain Coronary Artery Bypass Graft Pericarditis Blog 52

Dr. Smith's ECG Blog

MARCH 28, 2017

She was treated medically for NonSTEMI, pending next day cath, which showed ulcerated plaque and a 60% thrombotic stenosis in the LAD distal to the first diagonal. It was stented. Regional wall motion abnormality-distal septum and apex. Learning Points : 1. Always get serial ECGs when there is any doubt about what is going on.

STEMI 40

STEMI Risk Factors Bicuspid/Mitral Ultrasound 40

Dr. Smith's ECG Blog

DECEMBER 10, 2024

She underwent angiogram within a few hours and was found to have mid-RCA culprit lesion, 99% stenosis, TIMI 3 flow. Rather, they tell you what has been going on in the last several hours: 1) Echocardiogram -- The myocardium remains stunned and hypokinetic after reperfusion. Initial troponin (high sensitivity trop I): 212 ng/L.

Chest Pain 108

Chest Pain Ischemia Echocardiogram Stent 108

Dr. Smith's ECG Blog

NOVEMBER 10, 2024

Echocardiogram: EF 42% Moderate hypokinesis of the mid anterolateral and apical lateral myocardium Final diagnosis by the cardiologist was "STEMI" despite never meeting STEMI criteria. The patient was prompted taken to the cath lab — where a "culprit" mid-LCx lesion was found and successfully stented.

STEMI 81

STEMI Chest Pain Echocardiogram Stent 81