Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

IntroductionDelirium is an acute cognitive or perceptual disturbance that is associated with prolonged hospital and ICU length of stay, therefore, extending recovery time. This is secondary to delayed postoperative cerebral ischemia and infarction caused by vasospasm.7

Aneurysm 40

Aneurysm Stroke Strokes Ischemia 40

Dr. Smith's ECG Blog

JUNE 23, 2024

This was interpreted by the treating clinicians as not showing any evidence of ischemia. Given the presentation, the cardiologist stented the vessel and the patient returned to the ICU for ongoing critical care. He was intubated in the field and sedated upon arrival at the hospital. Two subsequent troponins were down trending.

Chest Pain 112

Chest Pain Cardiac Arrest Sudden Cardiac Death Stent 112

Dr. Smith's ECG Blog

SEPTEMBER 29, 2018

Normally, concavity in ST segments suggests absence of anterior ischemia (though concavity by itself is not reassuring - see this study ). It was thought to be an in stent restenosis and thrombosis from a DES placed in the same region 6 months prior. In there ECG evidence of possible ongoing ischemia? (ie,

Chest Pain 52

Chest Pain Myocardial Infarction Cardiac Arrest Ischemia 52

Dr. Smith's ECG Blog

JANUARY 6, 2023

I do not think this ECG is by itself diagnostic of OMI (full thickness, subepicardial ischemia ), b ut comparison to a previous might reveal this ECG as diagnostic of OMI. The facility was not pressed to activate emergent transfer for PCI since the pain was improving and suggested we optimize pain control and admit to the Cardiac ICU.

Chest Pain 52

Chest Pain Ischemia Myocardial Infarction ICU 52

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. Are you confident there is no ischemia? Primary VT , and the VT with tachycardia is causing ischemia with chest discomfort (supply-demand mismatch/type 2 MI)? The last echocardiography 12 months ago showed HFmrEF.

Tachycardia 102

Tachycardia Electrophysiology Atrial Flutter Ischemia 102

Dr. Smith's ECG Blog

OCTOBER 26, 2011

An open 90% LAD was stented. A 51 year old male with h/o stent presented with 30 minutes of chest pain: Obvious anterolateral very acute STEMI with hyperacute T-waves He went for immediate PCI, with successful reperfusion of a 100% occluded proximal LAD, and a door to balloon time of 35 minutes. The LAD has reperfused early.

STEMI 52

STEMI Myocardial Infarction Chest Pain Angioplasty 52