Remove Ischemia Remove Risk Factors Remove Stents
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Risk factors, prevention, and therapy of intraluminal stent thrombosis in frozen elephant trunk prostheses—what we know so far

Frontiers in Cardiovascular Medicine

In this phenomenon, a thrombus forms within the lumen of the stent graft component of the frozen elephant trunk prosthesis and puts the patient at risk for downstream embolization with visceral or lower limb ischemia. Therefore, the presence of ILT is associated with increased short-term mortality and morbidity.

Stent 59
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An undergraduate who is an EKG tech sees something. The computer calls it completely normal. How about the physicians?

Dr. Smith's ECG Blog

This EKG is diagnostic of transmural ischemia of the inferior wall. If it is angina, lowering the BP with IV Nitroglycerine may completely alleviate the pain and the (unseen) ECG ischemia. Transmural ischemia (as seen with the OMI findings on ECG) is not very common with demand ischemia, but is possible. Smith SW. .

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Precordial ST depression. What is the diagnosis?

Dr. Smith's ECG Blog

Precordial ST depression may be subendocardial ischemia or posterior STEMI. I have warned in the past that one must think of other etiologies of ischemia when there is tachycardia. The OM-1 was opened and stented, then the LAD was stented 3 days later. There is no ST elevation. How can we tell the difference?

STEMI 52
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Missed Acute MI, with coronary occlusion, evidence only by T-wave inversion in V2 and evolving ST depression in V3

Dr. Smith's ECG Blog

A 39 yo otherwise healthy man with no risk factors was walking at the mall when he developed chest pressure. Thus, there are some suspicious abnormalities, but no definite signs of ischemia. The difference is significant and highly suggests posterior ischemia. He was diaphoretic. It is very subtle but real.

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Abstract 254: Imaging Findings of Stroke Following Treatment of Ruptured Cerebral Aneurysm Increases Risk of Postoperative Delirium

Stroke: Vascular and Interventional Neurology

5 ICSS‐ MRI study (International Carotid Stenting Study Magnetic Resonance Imaging Study), indicated that patients with periprocedural hemodynamic depression had decreased cerebral blood flow and increased the risk of new lesions in imaging.6 Additional risk factors (delirium vs no delirium) included a history of stroke (17.5%/7.8%),

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The Computer and Overreading Cardiologist call this completely normal. Is it?

Dr. Smith's ECG Blog

The patient’s angiogram should have been expedited, but the EKG change was not recognized as recurrence of transmural ischemia. RAO Caudal View Post PCI This is the RAO Caudal view after thrombectomy and stent placement. The conventional computer algorithm called “ sinus tachycardia, otherwise normal EKG ”.

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An athletic 30-something woman with acute substernal chest pressure

Dr. Smith's ECG Blog

She had zero CAD risk factors. Now you have ECG and troponin evidence of ischemia, AND ventricular dysrhythmia, which means this is NOT a stable ACS. The lesion was stented. It they are static, then they are not due to ischemia. This is better evidence for ischemia than any other data point.

SCAD 52