DAIC

JULY 23, 2024

First runner-up for the YIA is Seokhun Yang, MD , of Seoul National University Hospital, for his abstract, “Prognostic Implications Of Coronary CT Angiography-derived Plaque And Hemodynamic Features On Acute Coronary Syndrome Across Varying Time Intervals: Emerald-ii Study.” and the Ma Family, who provided a $5,000 case prize for the winner.

Chest Pain 105

Chest Pain Plaque Coronary Artery Disease Ischemia 105

Stroke Journal

JANUARY 30, 2025

Understanding plaque evolution can help in risk stratification and in selecting proper therapies.Hypothesis:In this study, we hypothesized that vessel wall radiomics and hemodynamic features correlate with longitudinal change in plaque volume.Methods:Patients with ICAD and history of cerebral ischemia were included.

Plaque 40

Plaque Ischemia Stroke Strokes 40

Dr. Smith's ECG Blog

NOVEMBER 26, 2018

The axiom of "type 1 (ACS, plaque rupture) STEMIs are not tachycardic unless they are in cardiogenic shock" is not applicable outside of sinus rhythm. In some cases the ischemia can be seen "through" the flutter waves, whereas in other cases the arrhythmia must be terminated before the ischemia can be clearly distinguished.

Ischemia 52

Ischemia Atrial Flutter Arrhythmia Tachycardia 52

DAIC

FEBRUARY 13, 2024

High Diagnostic Accuracy Of AI-Ischemia in Comparison To PET, FFR-CT, SPECT, and Invasive FFR: A PACIFIC Sub-Study. Derivation, Validation and Prognostic Assessment of an AI-Based Algorithm for Determination of Coronary Ischemia: The CREDENCE and PACIFIC Trial. With Plaque Features Associated with False Positives.

Coronary Artery Disease 103

Coronary Artery Disease Ischemia Atherosclerosis Cardiovascular Imaging 103

DAIC

MAY 8, 2024

6 This novel study marks a significant milestone in the field, evaluating the effectiveness of FFR CT in detecting ischemia-producing coronary stenosis in patients with severe PAD. Diagnosis and treatment of ischemia-producing coronary stenoses improves 5-year survival of patients undergoing major vascular surgery.” 2024, [link].

Coronary Artery Disease 111

Coronary Artery Disease Chest Pain Ischemia Myocardial Infarction 111

DAIC

APRIL 2, 2025

Angiography has limitations that make it difficult to determine the true artery size and the makeup of the plaque, and is suboptimal in determining whether the stent is fully expanded post-PCI and identifying other complications that affect the safety and effectiveness of the procedure.

Stents 40

Stents Stent Outcomes Coronary Angiogram 40

Dr. Smith's ECG Blog

NOVEMBER 15, 2023

This suggests further severe ischemia. MINOCA may be due to: coronary spasm, coronary microvascular dysfunction, plaque disruption, spontaneous coronary thrombosis/emboli , and coronary dissection; myocardial disorders, including myocarditis, takotsubo cardiomyopathy, and other cardiomyopathies. And yet the arteries remain open.

Coronary Angiogram 109

Coronary Angiogram Plaque Thrombosis STEMI 109

American College of Cardiology

FEBRUARY 2, 2024

Typically, ischemia is associated with epicardial coronary artery obstruction caused by atherosclerotic plaque. Ischemic cardiovascular disease (IHD) continues to be a significant public health problem in the U.S.

Public Health 50

Public Health Plaque Ischemia Cardiovascular Disease 50

Dr. Smith's ECG Blog

JANUARY 4, 2021

This suggests diffuse subendocardial ischemia. However, along with that subendocardial ischemia, there is also STE in lead III with reciprocal ST depression in aVL, and some STE in V1. If there is also subendocardial ischemia, the ST depression vector remains leftward, with a reciprocal ST Elevation vector also to the right.

Ischemia 40

Ischemia Pulmonary STEMI Chest Pain 40

Frontiers in Cardiovascular Medicine

JUNE 26, 2024

ACS may arise from the disruption of an atherosclerotic plaque, ultimately leading to acute ischemia and myocardial infarction. Colchicine exerts anti-inflammatory properties affecting both the myocardium and atherosclerotic plaque by modulating the activity of monocyte/macrophages, neutrophils, and platelets.

Plaque 52

Plaque Myocardial Infarction Atherosclerosis Ischemia 52

DAIC

MAY 16, 2024

PAD is a serious, progressive cardiovascular disease primarily caused by a buildup of fatty plaque in the blood vessels, or atherosclerosis. This plaque narrows the blood vessels and reduces blood flow to the legs and feet, which may significantly impair physical function, walking performance and quality of life.

Peripheral Arterial Disease 105

Peripheral Arterial Disease Exercise Ischemia Quality of Life 105

DAIC

OCTOBER 1, 2024

tim.hodson Tue, 10/01/2024 - 10:50 PHOTO CAPTION: The Elucid PlaqueIQ user interface is a fully interactive visualization of the patient’s coronary anatomy, showing specific plaque type and amount across various views to inform physician assessment of risk and patient-specific treatment pathway.

Cardiovascular Disease 52

Cardiovascular Disease Plaque Quality of Life Myocardial Infarction 52

Dr. Smith's ECG Blog

OCTOBER 20, 2024

The first task when assessing a wide complex QRS for ischemia is to identify the end of the QRS. The ST segment changes are compatible with severe subendocardial ischemia which can be caused by type I MI from ACS or potentially from type II MI (non-obstructive coronary artery disease with supply/demand mismatch). What do you think?

Cardiogenic Shock 128

Cardiogenic Shock Ischemia Chest Pain Cardiac Arrest 128

All About Cardiovascular System and Disorders

APRIL 10, 2024

IVUS Measurements Measurements include the measurement of lumen, plaque, calcium, remodeling, stent length and volumetric measurements. Plaque morphology assessment with IVUS Plaque morphology can be assessed in terms of its geometry and echogenicity. A vulnerable plaque and a plaque with ulceration or rupture can also be found.

Ultrasound 52

Ultrasound Plaque Stents Stent 52

Dr. Smith's ECG Blog

DECEMBER 7, 2023

This proves effective treatment of the recurrent ischemia. The patient had no further symptoms of ischemia. Learning Points: Type 1 MI is the type we are most familiar with: rupture of atherosclerotic plaque with production thrombus or platelet fibrin aggregates. This proves effective treatment of the recurrent ischemia."

SCAD 124

SCAD Ischemia Coronary Artery Disease Cardiomyopathy 124

Dr. Smith's ECG Blog

MARCH 1, 2023

The precordial STD persists in severity from V4-V6, rather than being maximal in V1-V4 (as in posterior OMI), and so the ECG overall best fits the subendocardial ischemia pattern (diffuse supply/demand mismatch). Meyers serves as a reminder of the important clinical entity known as diffuse subendocardial ischemia.

Chest Pain 52

Chest Pain Ischemia Tachycardia Stenosis 52

Dr. Paddy Barrett

AUGUST 1, 2023

A CTCA provides much more anatomical detail and can identify advanced plaque often missed by CT Coronary Artery Calcium Score scans alone. There are 3 types of coronary atherosclerosis visible on CTCA: Calcified Plaque - Easily Identified on both CT CAC & CTCA scans. Subscribe now How Often Does A CT CAC Scan Miss Plaque?

Coronary Angiogram 52

Coronary Angiogram Plaque Coronary Artery Disease Chest Pain 52

Dr. Smith's ECG Blog

NOVEMBER 3, 2023

The baseline ECG is basically normal with no ischemia. You can see in the lead-specific analysis that she "sees" the STD in V5, V5, and II, with STE in aVR as signs of "Not OMI", because subendocardial ischemia pattern is not the same as OMI. In my opinion, I think it looks more like subendocardial ischemia.

Chest Pain 82

Chest Pain Cardiogenic Shock Ischemia Myocardial Infarction 82

Stroke: Vascular and Interventional Neurology

FEBRUARY 19, 2024

We summarized the current clinical evidence on the use of dual‐energy computed tomography for identifying early cerebral ischemia, detecting and predicting hemorrhagic transformations, and characterizing clots and stenotic plaques.

Stroke 40

Stroke Strokes Ischemia Hemorrhage 40

EMS 12-Lead

JULY 24, 2023

It should be known that each category can easily manifest the generic subendocardial ischemia pattern. In general, subendocardial ischemia is a consequence of global supply-demand mismatch that usually ameliorates upon addressing, and mitigating, the underlying cause. What’s interesting is that the ECG can only detect ischemia.

Angina 52

Angina Ischemia Coronary Angiogram Stenosis 52

DAIC

JANUARY 3, 2024

Traditional methods of non-invasive ischemia testing (stress EKG , stress echo, SPECT , PET , direct-to-cath) can result in false negatives 20-30 percent of the time, which can lead to undetected disease, and false positives over 50 percent of the time, which can lead to unnecessary invasive procedures.

Coronary Artery Disease 59

Coronary Artery Disease Chest Pain Plaque Technology 59

MIBHS

OCTOBER 31, 2024

Coronary Artery Disease (CAD) CAD, which involves the narrowing or blockage of coronary arteries due to plaque buildup, can reduce blood flow to the heart. This may result in ischemia (lack of oxygen to the heart muscle), causing parts of the heart to weaken and enlarge.

Blood Pressure 52

Blood Pressure Blood Clot Heart Valves Heart Rhythm 52

Dr. S. Venkatesan MD

FEBRUARY 25, 2024

However ,we have some effective clinical and pathological markers too, for effective re-vascularisation They are clinical well being and good functional capacity , relief from chest-pain, reduction of plaque volume, plaque stabilisation, maintenance of collaterals , microvascular patency , reduction of recurrent events.

Chest Pain 59

Chest Pain Plaque Stents Stent 59

Dr. Smith's ECG Blog

FEBRUARY 20, 2009

She is diagnosed with "demand ischemia" and discharged home. (#2) She had the following EKG at 0700 : (#3) Here there is 4 mm of ST elevation that can only be due to myocardial ischemia. There was a ruptured plaque with thrombus in the LAD, with some flow still (accounting for the inverted T waves). Echo the next day is normal.

Chest Pain 52

Chest Pain STEMI Ischemia Plaque 52

Dr. Paddy Barrett

NOVEMBER 28, 2023

Arteries generally narrow and occlude for one of two reasons: The progressive accumulation of plaque. A plaque ruptures, and a clot forms in the artery, thereby occluding it. There are the ‘garden variety’ heart attacks whereby a plaque ruptures in the coronary artery, called a spontaneous heart attack. N Engl J Med.

Stents 52

Stents Stent Heart attacks Heart Attack 52

Dr. Smith's ECG Blog

JUNE 23, 2024

This was interpreted by the treating clinicians as not showing any evidence of ischemia. His ECG at the accepting facility is shown below: Accepting facility ECG The team reviewed his angiography films with an interventionalist and thought they were suspicious for plaque rupture in LAD, but they were not confident.

Chest Pain 118

Chest Pain Cardiac Arrest Sudden Cardiac Death Blog 118

Dr. Smith's ECG Blog

MARCH 22, 2024

The fact that R waves 2 through 6 are junctional does make ischemia more difficult to interpret -- but not impossible. Back to the assessment of ischemia: Returning to the ECG, the leads that catch my eye first are -- I, II, V4, V5, V6. Ischemia can be disguised by a wide escape rhythm, which decreases the sensitivity of ECG.

Chest Pain 114

Chest Pain STEMI Bradycardia Ischemia 114

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

His response: “subendocardial ischemia. Smith : It should be noted that, in subendocardial ischemia, in contrast to OMI, absence of wall motion abnormality is common. With the history of Afib, CTA abdomen was ordered to r/o mesenteric ischemia vs ischemic colitis vs small bowel obstruction. Anything more on history?

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52

Heart 2023 Conference

APRIL 20, 2022

Source: JAMA Cardiology) Patients with afib who survived an intracerebral haemorrhage had a very significant risk of cerebrovascular ischemia episodes and death in the following year, according to registry data. JACC: Asia) Lexaria Bioscience has announced that a CBD product beats a placebo in simulating acute pulmonary hypertension.

Pulmonary 52

Pulmonary Hypertension AFIB COVID-19 52

Dr. Smith's ECG Blog

MARCH 17, 2024

Although radiation into the left arm is most classic for coronary ischemia, radiation into both arms is actually modestly more predictive ). The primary care physician's note indicates low suspicion for cardiac ischemia, but "for completion, check troponin and ECG." If an ECG was obtained in the office, it was not saved.

Angina 71

Angina Chest Pain Blog Ischemia 71

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

To prove there is no plaque rupture, you need to do intravascular ultrasound (IVUS). An angiogram is a "lumenogram;" most plaque is EXTRALUMINAL!! One of the most common is rupture of a non-obstructive plaque, with thrombus formation and OMI that spontaneously lyses and leaves a wide open artery. It can only be seen by IVUS.

Plaque 52

Plaque Chest Pain Thrombosis Stenosis 52

Dr. Smith's ECG Blog

MARCH 9, 2017

Smith comment: T-wave inversion such as seen in the first ECG can be seen with active non-transmural ischemia. But in this case, it is due to active ischemia, resolves with resolution of ischemia, and has little if any troponin elevation. If this patient was discharged from the ED she very likely would have died.

Chest Pain 52

Chest Pain Angina Ischemia Plaque 52

DAIC

JANUARY 23, 2024

Atherosclerotic cardiovascular disease (ASCVD), caused by plaque buildup in arterial walls, is one of the leading causes of disability and death worldwide.1,2 7 Research has shown inflammation plays a significant role in the development of atherosclerosis and ASCVD,8-10 and even the formation of plaque.11 4 In the U.S.

Cardiovascular Disease 111

Cardiovascular Disease Heart attacks Heart Attack Coronary Artery Disease 111

Dr. S. Venkatesan MD

OCTOBER 29, 2024

This study tested PTCA vs with a single lipid lowering drug in terms of plaque regression. Bertram Pitt and his team scripted this from the Department of Medicine, University of Michigan School of Medicine, Ann Arbor, USA. One can’t expect even in your dreams a study like this would be be done in the future.

Angioplasty 52

Angioplasty Coronary Artery Disease Plaque Angina 52

Dr. Smith's ECG Blog

NOVEMBER 9, 2023

Time 17 minutes Not much different One month earlier This is Left Bundle Branch Block (LBBB) without any sign of ischemia. Ramus: There is a large caliber branching ramus intermediate LAD is a medium caliber vessel that extends to the apex and is noted to have diffuse mild to moderate plaque in the midsegment. Post Procedure TIMI III.

Chest Pain 78

Chest Pain Echocardiogram Blog Ischemia 78

MIBHS

OCTOBER 15, 2024

For example, if a coronary artery becomes blocked due to plaque buildup (a condition known as coronary artery disease), the heart muscle may not receive enough oxygen, leading to chest pain (angina) or, in more severe cases, a heart attack. CAD is one of the leading causes of heart attacks.

Circulation 52

Circulation Heart attacks Heart Attack Chest Pain 52

Dr. Smith's ECG Blog

OCTOBER 10, 2022

In terms of ischemia, there is both a signal of subendocardial ischemia (STD max in V5-V6 with reciprocal STE in aVR) AND a signal of transmural infarction of the inferior wall with Q wave and STE in lead III with reciprocal STD in I and aVL. The rhythm is atrial fibrillation. The QRS complex is within normal limits. These include.

Cardiac Arrest 52

Cardiac Arrest Chest Pain Embolism Pulmonary 52