Embolism, Myocardial Infarction and Stents

Interventional thrombus modification in STEMI

Nature Reviews - Cardiology

APRIL 1, 2024

Nature Reviews Cardiology, Published online: 02 April 2024; doi:10.1038/s41569-024-01020-2 In ST-segment elevation myocardial infarction, the role of interventional modification of thrombi in the coronary arteries before stenting is controversial.

STEMI

STEMI Myocardial Infarction Embolism Stents

Modified percutaneous coronary intervention-derived risk models (PARIS and CREDO-Kyoto integer scoring systems) applied to Japanese transcatheter aortic valve replacement patients

Open Heart

JANUARY 19, 2023

Ischaemic events were defined as myocardial infarction, stroke, transient ischaemic attack or peripheral embolism at 1 year. Patterns of Non-adherence to Anti-Platelet Regimen in Stented Patients (PARIS) and Coronary Revascularisation Demonstrating Outcome Study in Kyoto (CREDO-Kyoto) integer scoring systems were tested.

Aortic valve

Aortic valve TAVR Aortic Myocardial Infarction

Initial Reperfusion T-waves, Followed by Pseudonormalization. Diagnosis?

Dr. Smith's ECG Blog

MARCH 11, 2016

Appearance of abnormal Q waves early in the course of acute myocardial infarction: implications for efficacy of thrombolytic therapy. It was treated with and dual "kissing balloons" and drug eluting stents. Midlateral wall rupture secondary to infero-postero-lateral infarction from circumflex occlusion was most common (34%).

Myocardial Infarction

Myocardial Infarction Pericarditis STEMI Angina

Webinars

Bridging Innovation & Patient Care: The Growing Role of AI

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Sometimes even ST Elevation meeting criteria is not enough to be convincing

Dr. Smith's ECG Blog

NOVEMBER 13, 2022

The ECG in ER is shown below: ECG is still diagnostic but we are watching the natural course of myocardial infarction here. You may see a filling defect in distal LAD, most probably due to an embolization from proximal lesion. The lesion was successfully stented, but it was unfortunately done after a significant myocardial loss.

Chest Pain

Chest Pain Myocardial Infarction Blog Pericarditis

See OMI vs. STEMI philosophy in action

Dr. Smith's ECG Blog

DECEMBER 22, 2022

Smith , d and Muzaffer Değertekin a DIFOCCULT: DIagnostic accuracy oF electrocardiogram for acute coronary OCClUsion resuLTing in myocardial infarction. Bi-phasic scan showed no dissection or pulmonary embolism. The lesion was successfully stented. Aspirated thrombotic material. References 1. Turk Kardiyol Dern Ars.

STEMI

STEMI Chest Pain Myocardial Infarction Electrocardiogram

A man in his early 40s with chest pain a "normal ECG" by computer algorithm. Should we avoid interrupting a physician to interpret his ECG?

Dr. Smith's ECG Blog

MAY 23, 2023

And they of course activated the cath lab immediately, where he was found to have acute thrombotic occlusion (TIMI 0) of the proximal LAD, as well as embolic D1 occlusion. LAD and D1 were stented, but flow unfortunately could not be well restored despite efforts (they list the post intervention TIMI flow still as 0).

Chest Pain

Chest Pain STEMI Blog Stents

Persistent Chest Pain, an Elevated Troponin, and a Normal ECG. At midnight.

Dr. Smith's ECG Blog

DECEMBER 14, 2016

Acute myocardial injury: Is it myocardial infarction, or perhaps myocarditis? The patient had been on a long drive, suggesting possible pulmonary embolism (this was unlikely given absence of tachyardia, hypoxia, or any other feature of PE), so we sent a d dimer. [We Is it acute or chronic? Is it STEMI or NonSTEMI?

Chest Pain

Chest Pain STEMI Aortic Pulmonary

Is there a Right Ventricular MI in addition to Infero-postero-lateral MI?

Dr. Smith's ECG Blog

JULY 11, 2018

However, by the time of the angiogram it had embolized distally, and had only done so after the right sided ECG was recorded. He did, found the true culprit, and went back in to stent it. See this case in which I saw STE in V1 and called the angiographer to suggest he look more closely at the angiogram.

Chest Pain

Chest Pain STEMI Ischemia Blog

A 30-something woman with intermittent CP, a HEART score of 2 and a Negative CT Coronary Angiogram on the same day

Dr. Smith's ECG Blog

MAY 10, 2023

ng/mL This single initial troponin at this level, in the context of chest pain, is high enough to be diagnostic of acute myocardial infarction. INTERVENTION * Successful angioplasty and stenting (drug eluting) of the mid LAD * Successful angioplasty of the ostial 1st diagonal Learning points: 1. Young women do get acute MI 2.

Coronary Angiogram

Coronary Angiogram Chest Pain Stenosis STEMI

Myocardial infarction and pulmonary embolism in pancreatic cancer: a case report of two manifestations of Trousseau's syndrome

Frontiers in Cardiovascular Medicine

MARCH 30, 2025

IntroductionThe simultaneous occurrence of acute myocardial infarction (AMI) and venous thromboembolism (VTE) is rare and often associated with underlying malignancies. Subsequent investigations revealed pulmonary embolism, deep vein thrombosis, and imaging findings suggestive of pancreatic cancer.

Myocardial Infarction

Myocardial Infarction Embolism Cancer Pulmonary

Pay now (in the evening) or pay later with interest (in the middle of the night).

Dr. Smith's ECG Blog

MARCH 1, 2025

He reports this was similar to how he felt when he had his heart attack 4 years prior, now s/p 4 stents. A 50 something male presented in the evening to ED for evaluation of chest pain that started at 1600. He states that it feels like burning and pressure, like GERD. The history gives a subtle hint that this might be another acute OMI.)

Chest Pain

Chest Pain STEMI Stents Stent

Patient is informed of her husband's death: is it OMI or it stress cardiomyopathy?

Dr. Smith's ECG Blog

MARCH 8, 2025

After stent deployment, we often see improvement in the ST-T within seconds or minutes. Third, a slow motion segment showing delayed, brisk filling of the PDA due to dislodgment of a thrombus from contrast injection and distal embolization. Here is the final angiogram following placement of a stent in the ostial RCA.

Cardiomyopathy

Cardiomyopathy Myocardial Infarction Defibrillator Bradycardia

Prehospital activation: De-activated on ED arrival by Cardiologist because "It's not a STEMI"

Dr. Smith's ECG Blog

OCTOBER 27, 2024

No pulmonary embolism is identified. Regardless of the ECG fingings, this management does not follow the ACC guidelines , which state that no matter what the ECG shows, if there is acute infarct and persistent pain the patient should go to the cath lab within 2 hours. First obtuse marginal also had an 80% stenosis and was stented.

STEMI

STEMI Chest Pain Myocardial Infarction Aneurysm

Cardiovascular Update

Interventional thrombus modification in STEMI

Modified percutaneous coronary intervention-derived risk models (PARIS and CREDO-Kyoto integer scoring systems) applied to Japanese transcatheter aortic valve replacement patients

Initial Reperfusion T-waves, Followed by Pseudonormalization. Diagnosis?

Webinars

Sometimes even ST Elevation meeting criteria is not enough to be convincing

See OMI vs. STEMI philosophy in action

A man in his early 40s with chest pain a "normal ECG" by computer algorithm. Should we avoid interrupting a physician to interpret his ECG?

Persistent Chest Pain, an Elevated Troponin, and a Normal ECG. At midnight.

Is there a Right Ventricular MI in addition to Infero-postero-lateral MI?

A 30-something woman with intermittent CP, a HEART score of 2 and a Negative CT Coronary Angiogram on the same day

Myocardial infarction and pulmonary embolism in pancreatic cancer: a case report of two manifestations of Trousseau's syndrome

Pay now (in the evening) or pay later with interest (in the middle of the night).

Patient is informed of her husband's death: is it OMI or it stress cardiomyopathy?

Prehospital activation: De-activated on ED arrival by Cardiologist because "It's not a STEMI"

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