Dr. Smith's ECG Blog

SEPTEMBER 9, 2024

You can easily imagine this patient getting one of several diagnoses -- vasospasm, MINOCA , pericarditis, or maybe even no diagnosis at all beyond "non-obstructive coronary artery disease." Fortunately, this operator used intravascular ultrasound (IVUS). An angiogram is a " lumenogram " and does not "see" the extraluminal plaque.

Plaque 65

Plaque Stent Stents Chest Pain 65

Dr. Smith's ECG Blog

OCTOBER 10, 2022

As in all ischemia interpretations with OMI findings, the findings can be due to type 1 AMI (example: acute coronary plaque rupture and thrombosis) or type 2 AMI (with or without fixed CAD, with severe regional supply/demand mismatch essentially equaling zero blood flow). Now another, with ultrasound. What is the Diagnosis?

Cardiac Arrest 52

Cardiac Arrest Chest Pain Embolism Pulmonary 52

Dr. Smith's ECG Blog

JANUARY 9, 2023

Pericarditis? Beware a negative Bedside ultrasound. This may occur as a result of blunt chest trauma or other acute stress that produces a sudden extreme shear force on a coronary artery ( that can result in an intimal tear that leads to intraluminal thrombosis ). 24 yo woman with chest pain: Is this STEMI?

Chest Pain 52

Chest Pain Aneurysm STEMI Thrombosis 52