Dr. Smith's ECG Blog

JULY 11, 2024

All three lesions had TIMI 2 flow prior to stenting. This is an RAO cranial projection of the left coronary vessels after thrombectomy and stenting. He now has regular appointments with the heart failure team. Queen of Hearts -- makes the diagnosis easy 3. The R waves have not recovered, however.

Outcomes 112

Outcomes Stenosis Outpatient Echocardiogram 112

Stroke Journal

FEBRUARY 1, 2024

vs. 46.2%) and history of congestive heart failure (8.0% Acute stenting was not associated with improved functional outcome at 90-days (aOR 0.86, 95% CI 0.41-1.82, Patients with tandem lesions were more likely to be men (60.6% vs. 46.6%,), have hyperlipidemia (60.9% vs. 52.1%), coronary artery disease (25.3% 1.82, p = 0.703).Conclusion:In

Hospital 40

Hospital Stroke Strokes Stent 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Baseline patient demographics and clinical characteristics recorded include age, gender, HbA1C level, National Institutes of Health Stroke Scale (NIHSS) at admission, manual CT ASPECTS and stroke risk factors (hypertension, atrial fibrillation, coronary artery disease, congestive heart failure, LDL, smoking, history of stroke/TIAs).

Outcomes 40

Outcomes Angioplasty Atrial Fibrillation Diabetes 40

Dr. Smith's ECG Blog

JANUARY 9, 2024

The patient is female in her 80s with a medical hx of previous MI with PCI and stent placement. Slow VT below the detection rate of the ICD lead to worsening heart failure and low stroke volume. Post conversion of VT the patient had low output cardiac failure and became unstable and hypoperfused.

Tachycardia 119

Tachycardia Electrophysiology Atrial Flutter Ischemia 119

Dr. Smith's ECG Blog

MAY 20, 2024

Smith comment 2: I frequently see failure to control BP in patients with acute chest pain or acute heart failure. This was a presumed culprit and a stent was placed. The angiogram showed scattered mild luminal irregularities of the LAD, the LCx, and the RCA and a 95% distal RCA occlusion in a right dominant system.

Chest Pain 125

Chest Pain Blood Pressure Ischemia STEMI 125

American College of Cardiology

FEBRUARY 1, 2025

7 The use of antiplatelet agents to prevent stent thrombosis, moderate- to high-dose statin therapy after acute coronary syndromes, or antihypertensive agents in asymptomatic patients may all be perceived by patients as not providing benefit because they may not feel the effects.8 BMC Med2015;13(74). Page RL 2nd, O'Bryant CL, Cheng D, et al.

Cardiovascular Disease 40

Cardiovascular Disease Coronary Artery Disease CMS Hospital 40

Dr. Smith's ECG Blog

AUGUST 6, 2024

In a word — Patient #2 was lucky to have his ECG interpreted by the Queen Of Hearts. This led to immediate cath lab activation — which revealed total occlusion of a large 1st diagonal branch that was stented. == Below is the ECG of Patient #3 — recorded from a 35-year old man with sudden, new-onset CP.

Chest Pain 104

Chest Pain Ischemia Pericarditis Tachycardia 104

Dr. Smith's ECG Blog

JUNE 11, 2021

Accordingly, in the algorithm by Cai et al for patients with LBBB and ischemic symptoms ( See below ) — the first indication for PCI is clinical: patients with hemodynamic instability or acute heart failure. So the RCA was stented. But by this time the patient went into cardiogenic shock and passed away.

Chest Pain 52

Chest Pain Cardiac Arrest Ischemia Cardiogenic Shock 52

Dr. Smith's ECG Blog

MARCH 22, 2024

And finally, after placement of a stent in the LAD: Before and after: (Unfortunately, this resulted in the "jailing" of the septal branches behind the stent and probably some degree of plaque shift which is why they do not opacify well in the "after" shot. This was the cost of preventing infarction of the anterior wall.)

Chest Pain 114

Chest Pain STEMI Bradycardia Ischemia 114

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

This unique case highlights the diagnostic and therapeutic challenges of a patient with multiple vascular risk factors who suffered from strokes secondary to BHS.MethodsA 79‐year‐old man with a past medical history of peripheral artery disease, abdominal aortic aneurysm, myocardial infarction with drug eluding stents (on dual antiplatelet therapy (DAPT)), (..)

Stenosis 40

Stenosis Peripheral Arterial Disease Pacemaker Atherosclerosis 40

EMS 12-Lead

MARCH 19, 2023

He denied any known medical history, specifically: coronary artery disease, hypertension, dyslipidemia, diabetes, heart failure, myocardial infarction, or any prior PCI/stent. Breath sounds were clear in all lung fields. No appreciable skin pallor. He reported to be a social drinker, but used tobacco products daily.

Myocardial Infarction 52

Myocardial Infarction STEMI Coronary Angiogram Coronary Artery Disease 52

Dr. Smith's ECG Blog

DECEMBER 14, 2016

There was a normal creatinine and no evidence of heart failure and no other reason for chronic injury, so it must be acute. It was opened and stented with a door to balloon time of about 120 minutes (this is long for STEMI, but very short for a high risk Non STEMI). The pain was unrelieved. What do you want to do?

Chest Pain 52

Chest Pain STEMI Aortic Myocardial Infarction 52

Dr. Smith's ECG Blog

FEBRUARY 15, 2018

The patient was then taken to the cath lab an found to have a proximal RCA 100% thrombotic occlusion which was successfully stented. The patient was then taken to the cath lab an found to have a proximal RCA 100% thrombotic occlusion which was successfully stented. Progression of V2 showing posterior involvement.

Chest Pain 52

Chest Pain Critical Care Article Pacemaker 52

EMS 12-Lead

MAY 20, 2022

When OMI is captured in this early phase, there exists the highest amount of salvageable myocardium and least likelihood of heart failure at hospital discharge. A mid-LAD culprit lesion was identified and stented. This grading system is the time sensitive prelude to Q-wave (irreversible transmural scar) formation.

Cardiomyopathy 52

Cardiomyopathy Ischemia STEMI Coronary Angiogram 52

DAIC

MARCH 8, 2024

suffer from heart failure , and there are approximately 400,000 heart-failure-related deaths in this country each year. Patients with heart failure often experience reduced mobility, quality of life and ability to work; the disease also represents a significant public health care burden.

Blood Clot 98

Blood Clot Heart Failure Quality of Life Innovation 98

Frontiers in Cardiovascular Medicine

JANUARY 7, 2024

Background Stent thrombosis (ST) is an uncommon but serious complication of stent implantation. Methods The analysis included patients who received stent placement for the index acute coronary syndrome (ACS). drug-eluting stent (DES) vs. bare-metal stent (BMS) and anticoagulant with rivaroxaban vs. placebo].

Stents 64

Stents Stent Thrombosis Myocardial Infarction 64

DAIC

MAY 3, 2024

Around 10% of Deaths from Coronary Stenting, Balloon Angioplasty are Preventable 9. 24: SGLT-2 Inhibitors Show Mixed Results After Heart Attack 10. New Study Published in JACC: Heart Failure Reveals that Despite Significant Efforts to Improve Acute Heart Failure Treatment Over the Past 20 Years, Management Remains Unchanged

Angioplasty 105

Angioplasty Blood Pressure Heart Attack Heart attacks 105

DAIC

FEBRUARY 24, 2025

As a result, healthcare faces rising expenses from frequent emergency room visits, lengthy hospital stays, costly procedures like stent placements and bypass surgeries, as well as the long-term management of chronic conditions like heart failure (HF). These costs represent a massive portion of total health expenditures.

Hospital 52

Hospital Cardiovascular Disease Heart Failure Heart Attack 52

DAIC

APRIL 23, 2024

When the valve narrows, it does not open or close properly, making the heart work harder to pump blood throughout the body. Eventually, this causes the heart to weaken and function poorly, which may lead to heart failure and increased risk for sudden cardiac death. Presented at Heart Valve Society 2024, Boston, MA.

Aortic valve 111

Aortic valve Aortic Innovation Cardiothoracic 111

DAIC

JUNE 13, 2024

When the valve narrows, it does not open or close properly, making the heart work harder to pump blood throughout the body. Eventually, this causes the heart to weaken and function poorly, which may lead to heart failure and increased risk for sudden cardiac death. Presented at Heart Valve Society 2024, Boston, MA.

Aortic valve 109

Aortic valve Aortic Innovation Cardiothoracic 109

Frontiers in Cardiovascular Medicine

JANUARY 15, 2024

The outcomes of interest were all-cause death and major adverse cardiovascular events (MACE), including acute coronary syndrome (ACS), heart failure (HF), need for additional revascularization, target vessel revascularization (TVR), SCAD recurrence, and stroke. The overall reported in-hospital and follow-up mortality rates were 1.2%

SCAD 75

SCAD Coronary Artery Bypass Graft Outcomes Myocardial Infarction 75

DAIC

APRIL 8, 2024

The findings call into question the routine use of beta blockers for all patients following a heart attack, which have stood as a mainstay of care for decades. Approximately 50% of heart attack survivors do not experience heart failure. Over a median follow-up period of 3.5

Heart Attack 52

Heart Attack Heart attacks Heart Failure Myocardial Infarction 52

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Angioplasty and stenting typically require the administration of glycoprotein IIb/IIIa inhibitors and/or dual‐antiplatelets which may increase the risk of hemorrhage in the setting of recent thrombolysis administration.MethodsWe conducted a retrospective analysis of a prospectively maintained patient registry at a comprehensive stroke center.

Angioplasty 40

Angioplasty Thrombolysis Hemorrhage Stent 40

Dr. Sanjay Gupta

MARCH 6, 2022

So she went back in 4 weeks and this time saw another doctor who asked her to stop the inhalers and suggested that it could be her heart and organised a chest X-ray and blood tests. Medications that improve quality of life in heart failure for example include diuretics.

Chronic Disease 40

Chronic Disease Quality of Life Heart Failure Nursing 40

Cardiometabolic Health Congress

SEPTEMBER 13, 2024

INFINITY-SWEDEHEART Trial: This randomized controlled trial, developed by Elixir Medical, compared the DynamX® Coronary Bioadaptor System with the Resolute Onyx drug-eluting stent. Cribier’s pioneering TAVI work, highlighting his prototypes, including using sail cloth. FINEARTS Trial: Prof. Young Investigator Award on Imaging: Drs.

Hypertension 59

Hypertension Cardiovascular Disease Bicuspid/Mitral Arrhythmia 59

Cardiology Update

APRIL 9, 2024

Investigators assessed if empagliflozin could lower the risk of hospitalization for heart failure (HF) or death from cardiovascular disease (CVD). The primary non-inferiority endpoint was MACCE (a composite of cardiac death, MI, ischaemic stroke, stent thrombosis, or target vessel revascularisation).

Angina 52

Angina Myocardial Infarction Aortic valve Coronary Artery Disease 52

Dr. Smith's ECG Blog

OCTOBER 24, 2018

It was stented. The patient would not have been diagnosed with acute coronary syndrome and would not have had an angiogram, would have been discharged (or perhaps had a stress test, which would be negative), and would be at great risk of another event, possibly resulting in death or heart failure. Values: STE60V3 = 2.0,

STEMI 40

STEMI Angina Myocardial Infarction Plaque 40

Dr. Smith's ECG Blog

APRIL 8, 2016

This was stented. Heart failure leading to death was related to all subclasses of PVC. After pacing, there was no recurrence of Torsades. After resuscitation, he was found to have a 90% thrombotic lesion in the same saphenous vein graft to the right posterior descending artery. The patient stabilized. mEq/L: The STE is resolved.

STEMI 52

STEMI Myocardial Infarction Cardiac Arrest Arrhythmia 52

Society of Thoracic Surgeons - Research

APRIL 20, 2023

Adult Cardiac Surgery Database Lead Author Title Publication Date Jacob Raphael Red Blood Cell Transfusion and Pulmonary Complications: The Society of Thoracic Surgeons Adult Cardiac Surgery Database Analysis The Annals of Thoracic Surgery January 2024 Joseph Sabik Multi-Arterial versus Single-Arterial Coronary Surgery: Ten Year Follow-up of One Million (..)

Research 52

Research Coronary Artery Bypass Graft Aortic valve Congenital 52

Society of Thoracic Surgeons - Research

APRIL 20, 2023

Program Designations Access and Publications (A&P) 1 Participant User File (PUF) 2 Task Force on Funded Research (TFR) 3 Special Projects 4 Adult Cardiac Surgery Database Lead Author Title Publication Date William Keeling 2 National Trends in Emergency Coronary Artery Bypass Grafting European Journal of Cardiothoracic Surgery October 2023 Jake (..)

Research 52

Research Coronary Artery Bypass Graft Aortic valve Congenital 52

Dr. Smith's ECG Blog

MARCH 19, 2025

Case submitted by Andrew Grimes, Advanced Care paramedic, with additions from Jesse McLaren and Smith An 84-year-old male with a notable cardiac history (CABG, multiple stents) woke at 0500hrs with pressure in his chest, diaphoresis, and light-headedness. They end up with high mortality and needless heart failure.

Chest Pain 116

Chest Pain STEMI Stent Stents 116

Dr. Smith's ECG Blog

FEBRUARY 2, 2025

Total proximal LAD occlusion was found and stented at angiography soon after the ECG above. He was discharged home, but quickly bounced back 4 times within the next few months for worsening heart failure. Here are some images: Next morning ECG: Reperfusion findings are clear. 4 days later: Continued reperfusion.

Cardiac Arrest 86

Cardiac Arrest STEMI Blog Ischemia 86

Dr. Smith's ECG Blog

MARCH 8, 2025

After stent deployment, we often see improvement in the ST-T within seconds or minutes. Here is the final angiogram following placement of a stent in the ostial RCA. 2:04 PM, post stent deployment You can see that even after complete restoration of flow, the ECG still looks terrible, V most of all.

Cardiomyopathy 75

Cardiomyopathy Myocardial Infarction Defibrillator Bradycardia 75