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 126

Chest Pain Blood Pressure Ischemia STEMI 126

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." myocarditis).

Defibrillator 52

Defibrillator Circulation Plaque Cardiac Arrest 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

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. No signs for aortic dissection or pulmonary embolus. --"Results were discussed with the ordering physician. CAD-RADS category 1. --No

Coronary Angiogram 52

Coronary Angiogram Chest Pain Stenosis STEMI 52

MIBHS

OCTOBER 15, 2024

Without oxygen, the cells would quickly die, leading to a heart attack (myocardial infarction). From there, the right ventricle pumps the blood to the lungs via the pulmonary arteries for reoxygenation. Blood Re-enters Systemic Circulation Once deoxygenated blood reaches the right atrium, it flows into the right ventricle.

Circulation 52

Circulation Heart Attack Heart attacks Chest Pain 52

Dr. Smith's ECG Blog

JANUARY 21, 2025

Bedside POCUS showed very poor LV function and a few pulmonary B lines. A Chest X-ray did not show pulmonary edema. This was attributed to a "Type 2 MI", which is acute MI that is not due to ruptured plaque, but rather due to "supply demand oxygen mismatch". They made a final diagnosis of type II myocardial infarction.

Chest Pain 62

Chest Pain STEMI Tachycardia Myocardial Infarction 62