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For those who depend on echocardiogram to confirm the ECG findings of ischemia, this should be sobering. In this case, the duration of ischemia was so brief that there was no such evolution, and there was near-normalization. Ischemia may be so brief that Wellens' waves do not evolve 3. The peak troponin I was 0.364 ng/ml.
This has been termed a “STEMI equivalent” and included in STEMI guidelines, suggesting this patient should receive dual anti-platelets, heparin and immediate cath lab activation–or thrombolysis in centres where cath lab is not available. His response: “subendocardial ischemia. Anything more on history? POCUS will be helpful.”
ICAD group was defined as persistent occlusion or residual stenosis at the initial occlusion site. Successful recanalization was defined as Thrombolysis in Cerebral Ischemia score ≥2b. Patient outcomes at 3 months were assessed using modified Rankin Scale (mRS) scores, defining devastating outcomes as mRS 5-6.
Rescue treatment with stenting, balloon angioplasty, and/or intraarterial thrombolysis or antiplatelets are often required to treat the underlying stenosis. IntroductionIntracranial atherosclerotic disease (ICAD) is associated with up to 32% of posterior circulation strokes.1
Cath at approximately 0945: "The LAD had a 90% proximal stenosis with TIMI 3 flow which corresponds to his ECG although LV function remains preserved. With nitroglycerin there is improvement in the 90% stenosis but still persistent stenosis consistent with the dynamic nature of his presentation. Is this Acute Ischemia?
Meschia’s lecture, “Asymptomatic Carotid Stenosis: Current and Future Considerations,” will be presented Feb. Man’s winning presentation, Abstract 43, “Race-Ethnic Specific Trends in Stroke Thrombolysis Care Metrics in Relation to U.S. Chimowitz, M.B., Ch.B. , the recipient of the Ralph L. Susan Linder P.T.,
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