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

Dr. Sanjay Gupta

MARCH 6, 2022

This is an ultrasound (a bit like the type that we use on pregnant women to look at the baby). An ultrasound will allow you to visualise the heart, measure the sizes of the chambers, assess the heart valves and work out how well the heart functions as a pump. It is still possible to have ischemia without coronary disease.

Heart attacks 52

Heart attacks Heart Attack Heart Rhythm Exercise 52

Dr. Smith's ECG Blog

OCTOBER 24, 2019

This strongly suggests reperfusing RCA ischemia. Troponins, echocardiogram An echocardiogram showed inferobasilar hypokinesis, further supporting a diagnosis of regional ischemia , likely of the area supplied by the RCA. Here’s the angiogram of the RCA : No thrombus or plaque rupture in the RCA (or any coronary artery) was found.

Chest Pain 52

Chest Pain SCAD STEMI Cardiogenic Shock 52

DAIC

APRIL 2, 2025

and European societal guidelines that intravascular imaging with either optical coherence tomography (OCT) or intravascular ultrasound (IVUS) should be routinely used during complex coronary stent procedures, s ays first authorGregg W. These results extend the strong recommendations from recent U.S.

Stent 40

Stent Stents Outcomes Coronary Angiogram 40

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. Now another, with ultrasound. The rhythm is atrial fibrillation. What is the Diagnosis?

Cardiac Arrest 52

Cardiac Arrest Chest Pain Embolism Pulmonary 52

Dr. Smith's ECG Blog

OCTOBER 24, 2018

This was diagnosed by IVUS (intravascular ultrasound) as a ruptured plaque. This was clearly severe subepicardial ischemia causing ST Elevation, but it was not of a long enough duration to result in measurable infarct. As there was ruptured plaque, this is NOT Prinzmetal's angina. Values: STE60V3 = 2.0, It was stented.

STEMI 40

STEMI Angina Myocardial Infarction Plaque 40

Dr. Smith's ECG Blog

OCTOBER 7, 2019

RCA ischemia often results in sinus bradycardia from vagal reflex or ischemia of the sinus node. They did not have an ultrasound on the ambulance (some local crews are starting to utilize POC limited US in our service areas). Case continued EMS immediately transported, activated the cath lab and gave 324 mg aspirin en route.

Bradycardia 40

Bradycardia STEMI Cardiogenic Shock Ischemia 40

Dr. Smith's ECG Blog

JANUARY 9, 2023

Only after her troponin peaked at 500,000 ng/L did she get her angiogram, which showed a 100% left main occlusion due to ruptured plaque. Beware a negative Bedside ultrasound. She died before she could get a heart transplant. They just could not believe that a young woman could have an OMI. RBBB, LAFB, and STE in I, aVL, V2 and V3.

Chest Pain 52

Chest Pain Aneurysm STEMI Thrombosis 52

Circulation

NOVEMBER 11, 2024

Background:The presence of carotid plaque (CP) may serve as an indicator of panvascular atherosclerosis. We computed a Vascular Disease (VasD) score, integrating the presence of carotid plaque (CP) on carotid ultrasound, known coronary artery disease (CAD), and myocardial ischemia (MyI).

Exercise 40

Exercise Coronary Artery Disease Ultrasound Plaque 40

Dr. Smith's ECG Blog

NOVEMBER 17, 2024

The operator performed intravascular ultrasound and visualized acute plaque rupture with thrombus formation and placed a stent. There was reperfusion ischemia superimposed on benign T-wave inversion. Fortunately, the patient underwent immediate angiography. Smith : I agree with this. 70% with normal wall motion.

Chest Pain 109

Chest Pain Ischemia Stents Stent 109

Dr. Smith's ECG Blog

DECEMBER 16, 2024

But it also shows a massive area of total ischemia in the LAD territory: CT shows the infarct The CT is with contrast, which increases density (which looks more white). This was ruptured plaque with thrombus. And almost all of them could be detected by bedside ultrasound. No ECG was recorded after pain resolution. OMI is common.

Chest Pain 105

Chest Pain STEMI Aortic Ultrasound 105