Dr. Smith's ECG Blog

SEPTEMBER 11, 2024

Electrocardiographic Criteria to Differentiate Acute Anterior ST Elevation Myocardial Infarction from Left Ventricular Aneurysm. Smith : "What was the outcome?" Former resident: "Just saw cath report, LAD stent was 100% acutely occluded." They of course opened and stented it. You taught us well!"

Chest Pain 114

Chest Pain Aneurysm Stents Stent 114

Stroke Journal

FEBRUARY 1, 2024

In this study, we evaluate the safety and efficacy of TCAR in patients with symptomatic internal carotid artery disease compared with carotid endarterectomy (CEA) and carotid artery stenting (CAS).METHODS:A The primary outcomes included a 30-day stroke or transient ischemic attack, myocardial infarction, and mortality.

Myocardial Infarction 40

Myocardial Infarction Stents Stent Stenosis 40

Dr. Smith's ECG Blog

DECEMBER 27, 2023

Just before 10 AM, the patient received a stent to the culprit OM. Comparative early and late outcomes after primary percutaneous coronary intervention in st-segment elevation and Non–St-segment elevation acute myocardial infarction (from the Cadillac trial). Peak troponin was 12 ng/mL. Guagliumi, G., Iwaoka, R.

Chest Pain 131

Chest Pain Myocardial Infarction Blog Stents 131

Journal of Cardiovascular Pharmacology

OCTOBER 9, 2024

The comparative effect of a combination of anticoagulant (AC) and antiplatelet (AP) versus AC monotherapy on clinical outcomes in patients with AF presenting with GIB is not well characterized. Patients with atrial fibrillation (AF) taking antithrombotic (AT) therapy are at increased risk of gastrointestinal bleeding (GIB).

Atrial Fibrillation 40

Atrial Fibrillation Myocardial Infarction Kidney Disease Stents 40

Dr. Smith's ECG Blog

MARCH 9, 2013

A stent was placed. I have seen cases of Wellens' syndrome that were ignored because of either negative troponins or normal echo or both and the patient did not get an angiogram and had a bad outcome. Electrocardiographic diagnosis of reperfusion during thrombolytic therapy in acute myocardial infarction. de Zwaan C.,

Chest Pain 52

Chest Pain Myocardial Infarction Ischemia Angina 52

Open Heart

JANUARY 19, 2023

Ischaemic events were defined as myocardial infarction, stroke, transient ischaemic attack or peripheral embolism at 1 year. Patterns of Non-adherence to Anti-Platelet Regimen in Stented Patients (PARIS) and Coronary Revascularisation Demonstrating Outcome Study in Kyoto (CREDO-Kyoto) integer scoring systems were tested.

Aortic valve 52

Aortic valve TAVR Aortic Myocardial Infarction 52

Stroke: Vascular and Interventional Neurology

OCTOBER 2, 2023

BackgroundProcedural intravenous cangrelor has been proposed as an effective platelet inhibition strategy for stenting in acute ischemic stroke. Safety outcomes included rates of symptomatic intracranial hemorrhage, parenchymal hematoma type 2, petechial hemorrhage, and in‐stent thrombosis. 3.28];P=0.836). versus 0%;P=0.911).ConclusionCangrelor

Thrombosis 40

Thrombosis Hemorrhage Stent Stents 40

Dr. Smith's ECG Blog

OCTOBER 26, 2011

An open 90% LAD was stented. Here is the ECG the next AM: There was so little infarction that there are lateral, but no anterior reperfusion T-waves (normally, there would be Wellens' type waves after LAD reperfusion). Relationship of TIMI myocardial perfusion grade to mortality after administration of thrombolytic drugs.

STEMI 52

STEMI Chest Pain Myocardial Infarction Angioplasty 52

Dr. Smith's ECG Blog

NOVEMBER 3, 2023

A man in his 70s with past medical history of hypertension, dyslipidemia, CAD s/p left circumflex stent 2 years prior presented to the ED with worsening intermittent exertional chest pain relieved by rest. Yet this is rarely followed, and patient outcomes like this are the result once in a while. Am J Emerg Med. 2014;32:e5–e8.

Chest Pain 83

Chest Pain Cardiogenic Shock Ischemia Myocardial Infarction 83

Stroke Journal

FEBRUARY 1, 2024

The primary outcomes included 30-day combined stroke and transient ischemic attack (TIA), myocardial infarction (MI), and mortality. The primary outcomes included 30-day combined stroke and transient ischemic attack (TIA), myocardial infarction (MI), and mortality. This was explained in Figure 1.Results:A

Myocardial Infarction 40

Myocardial Infarction Stents Stent Stenosis 40

Dr. Smith's ECG Blog

AUGUST 6, 2024

The ECG is diagnostic of occlusion myocardial infarction (OMI). This led to immediate cath lab activation — which revealed total occlusion of a large 1st diagonal branch that was stented. == Below is the ECG of Patient #3 — recorded from a 35-year old man with sudden, new-onset CP. Patient #3 — turned out to have myocarditis.

Chest Pain 104

Chest Pain Ischemia Pericarditis Tachycardia 104

Dr. Smith's ECG Blog

MAY 30, 2023

Angiogram: Culprit Lesion (s): Thrombotic occlusion of the proximal RCA -- stented. Literature cited In inferior myocardial infarction, neither ST elevation in lead V1 nor ST depression in lead I are reliable findings for the diagnosis of right ventricular infarction Johanna E. Such an escape would have a wider complex.

Chest Pain 97

Chest Pain Myocardial Infarction STEMI Cardiogenic Shock 97

Dr. Smith's ECG Blog

NOVEMBER 15, 2013

Consequences of reocclusion after successful reperfusion therapy in acute myocardial infarction. It is important to recognize that coronary thrombosis is dynamic , with spontaneous opening and lysing of the thrombus in the infarct-related artery (we all have endogenous tPA and plasmin to lyse thrombi). It was stented.

Chest Pain 52

Chest Pain Thrombosis Myocardial Infarction STEMI 52

EMS 12-Lead

MARCH 19, 2023

He denied any known medical history, specifically: coronary artery disease, hypertension, dyslipidemia, diabetes, heart failure, myocardial infarction, or any prior PCI/stent. No appreciable skin pallor. He reported to be a social drinker, but used tobacco products daily. Here is the time-zero 12 Lead ECG.

Myocardial Infarction 52

Myocardial Infarction STEMI Coronary Angiogram Coronary Artery Disease 52

Dr. Smith's ECG Blog

JANUARY 3, 2022

It was a 60yo with a history of stents to the circumflex and right coronary arteries, who presented with 9 hours of fluctuating central chest pain. Prospective validation of current quantitative electrocardiographic criteria for ST-elevation myocardial infarction. Int J Cardiol 2019 2. -- Meyers HP, Bracey, Smith et al.

STEMI 52

STEMI Myocardial Infarction Chest Pain Ischemia 52

Dr. Smith's ECG Blog

JUNE 28, 2018

Characteristic electrocardiographic pattern indicating a critical stenosis high in left anterior descending coronary artery in patients admitted because of impending myocardial infarction. Electrocardiographic diagnosis of reperfusion during thrombolytic therapy in acute myocardial infarction. Am Heart J. Am Heart J.

Chest Pain 52

Chest Pain Myocardial Infarction STEMI Article 52

Dr. Smith's ECG Blog

MAY 23, 2023

LAD and D1 were stented, but flow unfortunately could not be well restored despite efforts (they list the post intervention TIMI flow still as 0). Serial tracings following stent placement confirmed the large extent of myocardial injury. LCX and RCA were described as "normal" in the cath report. Am J Emerg Med. 2021.11.023.

Chest Pain 98

Chest Pain STEMI Blog Stents 98

Dr. Smith's ECG Blog

FEBRUARY 10, 2022

In the STEMI/NSTEMI dichotomy, NSTEMI is supposed to mean non-occlusive myocardial infarction, but this patient had transient Occlusion MI that was at risk for re-occlusion (like ‘transient STEMI’). Notice also that there is new T-wave inversion in III with upright T-wave in aVL, confirming inferior infarction.

STEMI 40

STEMI Myocardial Infarction Chest Pain Angina 40

Dr. Smith's ECG Blog

JULY 31, 2018

This is diagnostic of myocardial infarction. The lesion was stented. In middle age women, it accounts for 22-35% of all ACS presentations 1,3 , and the reported incidence of ST-elevation myocardial infarction in this subset of patients is variable, but estimated to be between 24-50% 4. Int J Cardiol. 2016.01.188.

SCAD 52

SCAD Chest Pain Myocardial Infarction Ischemia 52

Dr. Smith's ECG Blog

DECEMBER 11, 2023

Occlusion myocardial infarction is a clinical diagnosis Written by Willy Frick (@Willyhfrick). Here is the angiogram after stent placement. The patient suffered a large infarct. St depression in lead AVL differentiates inferior st-elevation myocardial infarction from pericarditis. Circulation , 130 (25).

Myocardial Infarction 123

Myocardial Infarction Chest Pain STEMI Blood Pressure 123

Open Heart

MARCH 3, 2025

Background Drug-eluting stents (DESs) have become the gold standard of coronary angioplasty since their inception in 2002. We aimed to compare outcomes between a broad range of second-generation DP-DES and BP-DES in an all-comer population. vs 57.5%, p=0.010), a greater average number of stents implanted per patient (1.72±0.92

Stent 52

Stent Stents Myocardial Infarction Angioplasty 52

DAIC

APRIL 2, 2025

Stone, MD Mount Sinai Health System tim.hodson Wed, 04/02/2025 - 15:26 March 31, 2025 Using intravascular imaging (IVI) to guide stent implantation during complex stenting procedures is safer and more effective for patients with severely calcified coronary artery disease than conventional angiography, the more commonly used technique.

Stent 40

Stent Stents Outcomes Coronary Angiogram 40

Dr. Smith's ECG Blog

JANUARY 6, 2023

Smith comment: We have shown that use of opiates is associated with worse outcomes in ACS: Bracey, A. Association between opioid analgesia and delays to cardiac catheterization of patients with occlusion Myocardial Infarctions. A single DES stent was placed, and the patient did well post-procedure. Abstract 556.

Chest Pain 52

Chest Pain Ischemia Myocardial Infarction ICU 52

Dr. Smith's ECG Blog

FEBRUARY 4, 2022

They were stented. Emergent cardiac outcomes in patients with normal electrocardiograms in the emergency department. Available from: [link] Excerpt: "To illustrate the limitations imposed by sample size, recent data from our institution reveal that we identify approximately 225 type I myocardial infarctions (MI) in a typical year.

Chest Pain 52

Chest Pain STEMI Article Myocardial Infarction 52

Dr. Smith's ECG Blog

NOVEMBER 3, 2017

Electrocardiographic Differentiation of Early Repolarization FromSubtle Anterior ST-Segment Elevation Myocardial Infarction. After many hours, the decided that it was appropriate to do an angiogram and they found a distal LAD occlusion which was opened and stented. Outcome The cath lab was activated by the emergency physician.

Chest Pain 52

Chest Pain STEMI Bradycardia Stenosis 52

Dr. Smith's ECG Blog

DECEMBER 16, 2019

This case was texted to me by one of our residency graduates, and with the outcome, so I don't know how I would have interpreted it blindly. It was opened and stented. Comparison of the QRS Complex, ST-Segment, and T-Wave Among Patients with Left Bundle Branch Block with and without Acute Myocardial Infarction.

Chest Pain 52

Chest Pain Myocardial Infarction Stents Stent 52

Cardiology Update

MARCH 25, 2024

Left main coronary artery disease (CAD) and diabetes pose significant challenges in cardiovascular care, often leading to adverse outcomes. Preliminary evidence from trials focusing on patients with multivessel disease has hinted at diabetes as a potential modifier of treatment outcomes.

Diabetes 122

Diabetes Coronary Artery Bypass Graft Outcomes Coronary Artery Disease 122

Open Heart

JANUARY 19, 2024

Aims To estimate the 1-year cost-effectiveness of stepwise provisional versus systematic dual stenting strategies. Aims To estimate the 1-year cost-effectiveness of stepwise provisional versus systematic dual stenting strategies. Uncertainty was explored by probabilistic bootstrapping.

Stent 98

Stent Stents Myocardial Infarction Outcomes 98

DAIC

MARCH 13, 2024

suggest that the drug-coated balloon offers an effective treatment strategy for the management of coronary in-stent restenosis, or blockages recurring within previously placed stents. Smith Center for Outcomes Research in Cardiology and section chief of Interventional Cardiology at BIDMC. percent).

Angioplasty 116

Angioplasty Stents Stent Myocardial Infarction 116

Frontiers in Cardiovascular Medicine

JANUARY 15, 2024

This systematic review of the literature aims to explore outcomes in the patients treated with conservative management vs. invasive strategy. of the patients were diagnosed with non-ST elevated myocardial infarction (NSTEMI), 36.8% Approximately 48.5% The overall reported in-hospital and follow-up mortality rates were 1.2%

SCAD 75

SCAD Coronary Artery Bypass Graft Outcomes Myocardial Infarction 75

Coronary Artery Disease Journal

NOVEMBER 20, 2023

Background: Gender-specific outcomes after percutaneous coronary interventions were studied by a number of research groups with different endpoints and cohorts of different ethnic extractions. Materials and methods: The basis for this post hoc analysis was two large all-comers studies with prospectively enrolled patients from Europe and Asia.

Stents 52

Stents Stent Outcomes Coronary Artery Disease 52

Open Heart

JUNE 18, 2024

Background For high bleeding-risk patients (HBR) undergoing percutaneous coronary intervention (PCI), the LEADERS FREE (LF) and LEADERS FREE II (LF II) trials established the safety and efficacy of a stainless steel polymer-free biolimus-coated stent (SS-BCS) with 30 days of dual antiplatelet treatment (DAPT). to 9.2%) patients.

Stent 40

Stent Stents Outcomes Myocardial Infarction 40

Circulation: Cardiovascular Interventions

JANUARY 15, 2024

BACKGROUND:We previously reported the use of minimal stent area to predict angiographic in-stent restenosis after drug-eluting stent implantation for unprotected left main (LM) disease. Circulation: Cardiovascular Interventions, Volume 17, Issue 1 , Page e013006, January 1, 2024. mm2for distal LM (area under the curve, 0.57;P=0.15),

Stent 40

Stent Stents Myocardial Infarction Stenosis 40

Circulation

FEBRUARY 12, 2024

The 2 coprimary outcomes were target lesion revascularization and myocardial infarction. The secondary outcomes included ischemia-driven target lesion revascularization, target vessel myocardial infarction, death, cardiac death, target vessel revascularization, stent thrombosis, and major adverse cardiac events.

Ultrasound 67

Ultrasound Myocardial Infarction Thrombosis Stents 67

DAIC

MAY 14, 2024

The impact of this narrowing can ultimately result in angina (chest pain), which has been shown to double the risk of major cardiovascular events,1 as well as myocardial infarction ( heart attack ) or even death. Accessed May 2024. Kirtane, Yongjian Wu, William Wijns, Weixian Yang, Martin B. Leon, Shubin Qiao, Gregg W.

Coronary Artery Disease 111

Coronary Artery Disease Interventional Cardiology Innovation Physiology 111

Journal of the American Heart Association

APRIL 10, 2025

The primary outcome was the composite occurrence of stroke, myocardial infarction, and allcause death following carotid revascularization. A multivariate Cox regression analysis was conducted to assess the primary outcomes. years, 4087 patients experienced a primary outcome. Over a mean followup period of 4.133.14

Diabetes 40

Diabetes Outcomes Myocardial Infarction Stents 40

Open Heart

OCTOBER 26, 2022

Background Bioresorbable vascular scaffolds (BVS) were designed to reduce the rate of late adverse events observed in conventional drug-eluting stents (DES) by dissolving once they have restored lasting patency. All other outcomes were statistically equivalent. to 1.70; p=0.01) resulting from high rates of TVMI and ID-TLR.

Stent 52

Stent Stents Coronary Artery Disease Myocardial Infarction 52