Circulation

NOVEMBER 11, 2024

eGC shedding could contribute to atherosclerotic plaque vulnerability and acute myocardial infarction (AMI) installation. The integrity of this structure sustains some vascular properties such as shear stress-induced nitric oxide release and the prevention of platelets and neutrophils adhesion on the vessel surface.

Myocardial Infarction 40

Myocardial Infarction Plaque Technology Diabetes 40

Dr. Smith's ECG Blog

NOVEMBER 15, 2023

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. MINOCA I do not have the bandwidth here to write a review of MINOCA.

Coronary Angiogram 109

Coronary Angiogram Plaque Thrombosis STEMI 109

Frontiers in Cardiovascular Medicine

FEBRUARY 20, 2024

We investigated whether treatment with LDE-paclitaxel changes plaque progression by coronary CT angiography and is safe in patients with chronic coronary artery disease. Among those, 58% had diabetes, 50% had myocardial infarction, and 91% were in use of statin and aspirin.

Coronary Artery Disease 59

Coronary Artery Disease Laboratory Plaque Myocardial Infarction 59

Dr. Smith's ECG Blog

APRIL 22, 2024

A comparison of electrocardiographic changes during reperfusion of acute myocardial infarction by thrombolysis or percutaneous transluminal coronary angioplasty. Electrocardiographic diagnosis of reperfusion during thrombolytic therapy in acute myocardial infarction. Am Heart J. 2000;139:430–436. Am J Cardiol.

Chest Pain 117

Chest Pain Myocardial Infarction Anatomy Angina 117

DAIC

FEBRUARY 29, 2024

ET Main Tent (Hall B1) - A Double-blind, Randomized Placebo Procedure-controlled Trial of an Interatrial Shunt in Patients with HFrEF and HFpEF: Principal Results From the RELIEVE-HF Trial - Empagliflozin After Acute Myocardial Infarction: Results of the EMPACT-MI Trial - CSL112 (Apolipoprotein A-I) Infusions and Cardiovascular Outcomes in Patients (..)

Aortic valve 103

Aortic valve Myocardial Infarction Aortic Blood Pressure 103

Frontiers in Cardiovascular Medicine

FEBRUARY 5, 2024

Anaphylaxis leads to plaque rupture or erosion leading to acute myocardial infarction (type II) and acute coronary stent thrombosis (type III). Here we share a case of Kounis syndrome type I caused by an allergy caused by a Cryptopteran bite.

Coronary Artery Disease 64

Coronary Artery Disease Electrocardiogram Myocardial Infarction Thrombosis 64

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

The British Journal of Cardiology

AUGUST 1, 2024

Elevated Lp(a) concentrations in patients with ischaemic heart disease have been linked to higher rates of peri-procedural myocardial infarction (MI) during percutaneous coronary intervention (PCI). This review summarises the available data on the modulatory effect of Lp(a) on plaque morphology and recurrent ischaemic events.

Peripheral Arterial Disease 40

Peripheral Arterial Disease Myocardial Infarction Plaque Cardiovascular Disease 40

Dr. Smith's ECG Blog

JANUARY 5, 2024

So there is probability of myocardial injury here (and because it is in the correct clinical setting, then myocardial infarction.) Although it is statistically unlikely, multiple plaque ruptures are possible. The PDA plaque was also bulky, but was not described as inflamed or ulcerated. Heitner et al.

Angina 119

Angina Plaque Document Stents 119

DAIC

APRIL 7, 2024

As with elevated LDL-cholesterol, high levels of triglycerides and the lipid particles on which they are carried in the blood can contribute to the formation of “plaques” in the arteries that impede blood flow and can lead to heart attacks and strokes. Triglycerides store unused calories and provide energy to the body.

Cholesterol 116

Cholesterol Heart Attack Heart attacks Myocardial Infarction 116

Dr. Smith's ECG Blog

MAY 20, 2024

The scan also showed “scattered coronary artery plaques”. __ Smith comment 1 : the appropriate management at this point is to lower the blood pressure (lower afterload, which increases myocardial oxygen demand). Smith comment : Is the ACS (rupture plaque) with occlusion that is now reperfusing? Murakami MM.

Chest Pain 124

Chest Pain Blood Pressure Ischemia STEMI 124

Circulation

NOVEMBER 11, 2024

Background:The no-reflow has been reported to be associated with larger infarct size and mortality after acute myocardial infarction (AMI). The incidence of no-reflow was higher in patients with attenuated plaque ≥5 mm in length as evaluated by intravascular ultrasound (IVUS).Objective:The vs. 8.6%, p < 0.001).

Ultrasound 40

Ultrasound Plaque Blood Pressure Myocardial Infarction 40

All About Cardiovascular System and Disorders

APRIL 30, 2024

Plaque regression can be demonstrated by ultrasound evaluation of the carotids which are easily accessible. Maintaining normal blood pressure also reduces the risk of stroke and myocardial infarction. Of course, exercise burns out extra calories and reduces body weight, which in turn is due to a decrease in the fat deposits.

Exercise 52

Exercise Heart Disease Blood Pressure Cholesterol 52

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!! Such cases are classified as MINOCA (Myocardial Infarction with Non-Obstructed Coronary Arteries). It can only be seen by IVUS. MINOCA has many etiologies. Learning Points: 1.

Plaque 52

Plaque Chest Pain Thrombosis Stenosis 52

Dr. Smith's ECG Blog

MAY 19, 2020

If the arrest was caused by acute MI due to plaque rupture, then the diagnosis is MINOCA. MINOCA: Myocardial Infarction in the Absence of Obstructive Coronary Artery Disease). Here is my comment on MINOCA: "Non-obstructive coronary disease" does not necessarily imply "no plaque rupture with thrombus." FFR can be useful.

Defibrillator 52

Defibrillator Circulation Plaque Cardiac Arrest 52

Stroke Journal

NOVEMBER 9, 2023

This article describes the pathway from gene discovery to novel therapeutic approaches that are now entering man.HDAC9expression is elevated in human atherosclerotic plaque, while in animal and cellular models, reducing HDAC9 (histone deacetylase 9) protein is associated with reduced disease.

Stroke 40

Stroke Strokes Atherosclerosis Coronary Artery Disease 40

Circulation

NOVEMBER 11, 2024

She was diagnosed with NSTEMI with a thrombolysis in myocardial infarction (TIMI) score of 5. Her EKG showed marked left-axis deviation, ST depressions in V2-V4, and RBBB. PCI, particularly with the Carlino technique, offers a reliable approach.

Coronary Artery Disease 40

Coronary Artery Disease Chest Pain Myocardial Infarction Thrombolysis 40

Circulation

NOVEMBER 8, 2023

Permanent coronary ligation was performed to establish myocardial infarction (MI). Compared with animals without PCOS, PCOS animals showed significantly exacerbated atherosclerotic plaque development and post-MI cardiac remodeling.

Coronary Artery Disease 40

Coronary Artery Disease Myocardial Infarction Circulation Plaque 40

Dr. Smith's ECG Blog

NOVEMBER 3, 2023

Therefore it means acute type 1 ACS plaque rupture with impeded flow and impending full occlusion until proven otherwise. A New ST-segment elevation myocardial infarction equivalent pattern? Association between opioid analgesia and delays to cardiac catheterization of patients with occlusion Myocardial Infarctions.

Chest Pain 81

Chest Pain Cardiogenic Shock Ischemia Myocardial Infarction 81

Dr. Smith's ECG Blog

MARCH 17, 2024

Answer: This is MINOCA -- Myocardial Infarction with Non-Obstructive Coronary Arteries. Possible etiologies (depending on your definition) include: plaque rupture with spontaneous recanalization, coronary artery vasospasm, spontaneous coronary artery dissection, or other rarer causes. The name is self-explanatory.

Angina 70

Angina Chest Pain Blog Ischemia 70

Cardiology Update

JUNE 16, 2024

Recent research has illuminated the role of total coronary atherosclerotic plaque activity across the entire coronary arterial tree in predicting patient-level clinical outcomes. Vessel-level coronary atherosclerotic plaque activity was assessed using coronary 18 F-sodium fluoride positron emission tomography (PET). 3.72; P = 0.013).

Myocardial Infarction 98

Myocardial Infarction Plaque Coronary Artery Disease Research 98

Dr. Smith's ECG Blog

JULY 11, 2024

Case A 43 year old male with a history of DM II, hyperlipidemia, and a family history of myocardial infarction presented to a family clinic with two days of epigastric pain that started after consuming a meal. Because: 1) He has been reading this blog for a long time. 2) He is curious This is how Pendell got started.

Outcomes 112

Outcomes Stenosis Outpatient Echocardiogram 112

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

However, CTA head and neck 4 days later demonstrated 90 percent stenosis of the mid left V2 at the C3‐4 level and a 75‐90 percent stenosis of the left mid V2 segment at the C5‐6 level (hard and soft plaque in these areas). He was switched from DAPT to aspirin and warfarin because he was considered a “DAPT failure.”

Stenosis 40

Stenosis Peripheral Arterial Disease Pacemaker Atherosclerosis 40

Dr. Malcolm Kendrick

AUGUST 26, 2022

There are numerous other conditions leading to this kind of damage, which can trigger thrombus formation, causing strokes and myocardial infarctions. The thrombogenic hypothesis, that endothelial damage and subsequent clot formation underlies the formation and growth of plaques, may represent a better model for ASCVD.

Cardiovascular Disease 40

Cardiovascular Disease Cholesterol Article Plaque 40

Dr. Sanjay Gupta

DECEMBER 19, 2022

The term MINOCA stands for Myocardial infarction with non-obstructive coronary arteries. She had some very minor plaque but certainly nothing that could explain the heart attack and therefore she was discharged with a diagnosis of MINOCA i.e I’ll try and explain this a bit better by using a case study.

Heart Attack 40

Heart Attack Heart attacks Blood Clot Chest Pain 40

Dr. Smith's ECG Blog

JULY 31, 2018

This is diagnostic of myocardial infarction. 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. She felt more comfortable being admitted. Int J Cardiol.

SCAD 52

SCAD Chest Pain Myocardial Infarction Ischemia 52

Dr. Smith's ECG Blog

MARCH 27, 2018

It was actually a dissection, not an atherosclerotic plaque rupture. Here it is: Obvious mid-RCA severe stenosis, but there is flow (reperfusion, spontaneous, autolysis) Female patient: She had a 2nd Obtuse Marginal occlusion (Left dominant, off the circumflex!). Reperfusion early and without T-wave inversion! Learning Points 1.

Chest Pain 52

Chest Pain Myocardial Infarction Plaque STEMI 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

New insights into the use of the 12-lead electrocardiogram for diagnosing acute myocardial infarction in the emergency department. Here is the abstract: Background Identification of ST elevation myocardial infarction (STEMI) is critical because early reperfusion can save myocardium and increase survival.

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52

Dr. Smith's ECG Blog

OCTOBER 24, 2019

Here’s the angiogram of the RCA : No thrombus or plaque rupture in the RCA (or any coronary artery) was found. This MI wasn’t caused by a ruptured plaque of CAD - it was a coronary artery dissection of the RCA. Revascularization in Patients With Spontaneous Coronary Artery Dissection and ST-Segment Elevation Myocardial Infarction.

Chest Pain 52

Chest Pain SCAD STEMI Cardiogenic Shock 52

Dr. Smith's ECG Blog

JULY 11, 2018

Today, they viewed the angiogram and concluded that the thrombus at the mid RCA must have extended proximally from the culprit ruptured plaque, extending proximal to the RV marginal branch and temporarily occluding it. I saw this result the next day and it perplexed me, so I inquired with the cardiologists. The proposed mechanism is complex.

Chest Pain 52

Chest Pain STEMI Ischemia Blog 52

Dr. Smith's ECG Blog

JANUARY 4, 2021

Both of these patterns together suggest Aslanger's pattern , recently published in J Electrocardiology: A new electrocardiographic pattern indicating inferior myocardial infarction. Angiogram Culprit Lesion: 90% mid LAD stenosis with evidence of plaque rupture, TIMI III flow on angiography.

Ischemia 40

Ischemia Pulmonary STEMI Chest Pain 40

Cardiometabolic Health Congress

JANUARY 15, 2025

The Hidden Threat: SMuRFless Myocardial Infarctions A concerning trend in CVD is the increase in myocardial infarctions (MI) among individuals without standard modifiable risk factors (SMuRFless MI).

Atherosclerosis 59

Atherosclerosis Plaque Myocardial Infarction Risk Factors 59

Dr. Paddy Barrett

FEBRUARY 14, 2025

A heart attack is when that plaque ruptures and stops blood flow down the artery. This graph shows the absolute and relative risk reduction for statin therapy in preventing heart attacks (Myocardial Infarction), strokes and preventing death from any cause (All-cause mortality) 2. Cholesterol is an essential part of that process.

Cholesterol 114

Cholesterol Heart Disease Heart Attack Heart attacks 114

Dr. Smith's ECG Blog

MAY 10, 2023

ng/mL This single initial troponin at this level, in the context of chest pain, is high enough to be diagnostic of acute myocardial infarction. LAD plaque with 0-25 percent stenosis. I do not have her previous ECGs, but reportedly these T-wave inversions were not present previously. Her initial cTnI returned at 0.25

Coronary Angiogram 52

Coronary Angiogram Chest Pain Stenosis STEMI 52

DAIC

MARCH 31, 2025

mg tablet), ananti-inflammatory atheroprotective cardiovascular treatment, to reduce the risk of myocardial infarction (MI), stroke, coronary revascularization, and cardiovascular death in adult patients with established atherosclerotic disease or with multiple risk factors for cardiovascular disease. mg on atherosclerotic plaque.

Cardiovascular Disease 52

Cardiovascular Disease Plaque Coronary Artery Disease Heart Attack 52

Dr. Smith's ECG Blog

APRIL 8, 2022

The ECG is diagnostic for acute transmural infarction of the anterior and lateral walls, with LAD OMI being the most likely cause (which has various potential etiologies for the actual cause of the acute coronary artery occlusion, the most common of which is of course type 1 ACS, plaque rupture with thrombotic occlusion).

Chest Pain 52

Chest Pain SCAD STEMI Blog 52

DAIC

JULY 18, 2024

This registry will aim to provide world-wide physicians the most accurate information on coronary plaque to improve cardiovascular risk prediction and support the selection of patient-specific treatment,” said Dr. De Cecco. The ultimate goal is to positively impact cardiovascular health globally with a reduction in cardiovascular events."

Plaque 105

Plaque Heart Attack Heart attacks Cardiovascular Disease 105