Plaque and Pulmonary - Cardiovascular Update

Atherosclerotic Coronary Plaque Features in Patients with Chronic Obstructive Pulmonary Disease and Acute Coronary Syndrome

The American Journal of Cardiology

JUNE 12, 2024

Publication date: Available online 12 June 2024 Source: The American Journal of Cardiology Author(s): Michele Russo, Massimiliano Camilli, Giulia La Vecchia, Riccardo Rinaldi, Alice Bonanni, Matteo Pio Natale, Carmine Salzillo, Ilaria Torre, Carlo Trani, Filippo Crea, Rocco A.

Plaque

Plaque Pulmonary

A 40-something woman with acute pulmonary edema -- see the Speckle Tracking echocardiogram.

Dr. Smith's ECG Blog

APRIL 12, 2023

She had acute pulmonary edema on exam. On arrival, lung ultrasound confirmed pulmonary edema (B lines). Mild Plaque no angiographically significant obstructive coronary artery disease. A 49 year old woman with h/o COPD only presented with sudden dyspnea. This is proximal LAD Occlusion until proven otherwise.

Echocardiogram

Echocardiogram Pulmonary Cardiomyopathy Coronary Artery Disease

Avocados for the Heart; Cardiology's Sad State; CBD for Pulmonary Hypertension?

Heart 2023 Conference

APRIL 20, 2022

(Arteriosclerosis, Thrombosis and Vascular Biology) A role for hemoglobin in atherosclerosis is supported by a study that used serial coronary CT angiography to demonstrate an association between persistently low serum hemoglobin levels and greater changes in coronary plaque volume.

Pulmonary

Pulmonary Hypertension AFIB COVID-19

Understanding an Enlarged Heart (Cardiomegaly): Causes, Symptoms, and Treatment

MIBHS

OCTOBER 31, 2024

Coronary Artery Disease (CAD) CAD, which involves the narrowing or blockage of coronary arteries due to plaque buildup, can reduce blood flow to the heart. Blood Clots: An enlarged heart is more prone to developing blood clots, which can lead to stroke or pulmonary embolism.

Blood Pressure

Blood Pressure Blood Clot Heart Valves Heart Rhythm

ECG with Aslanger's Pattern. CT Pulmonary Angiogram Reveals LAD Ischemia (Septal Transmural). But this is not Contradictory.

Dr. Smith's ECG Blog

JANUARY 4, 2021

The patient was slightly tachypneic and mildly hypoxic in the stabilization room and therefore the physicians obtained a CT pulmonary angiogram as well as aortogram to rule out dissection and PE. Angiogram Culprit Lesion: 90% mid LAD stenosis with evidence of plaque rupture, TIMI III flow on angiography.

Ischemia

Ischemia Pulmonary STEMI Chest Pain

Understanding Coronary Circulation: The Steps that Keep Your Heart Pumping

MIBHS

OCTOBER 15, 2024

From there, the right ventricle pumps the blood to the lungs via the pulmonary arteries for reoxygenation. Here are a few issues that can arise: Coronary Artery Disease (CAD) : This occurs when plaque builds up inside the coronary arteries, narrowing them and restricting blood flow to the heart.

Circulation

Circulation Heart Attack Heart attacks Chest Pain

Elder Male with Syncope

EMS 12-Lead

APRIL 9, 2024

The CXR demonstrated no pulmonary edema. Sudden narrowing of a coronary artery due to ACS (plaque rupture with thrombosis and/or downstream showering of platelet-fibrin aggregates). There was equally no anemia, sepsis, or hypoxia—only transient hypotension in the field. The Trop I returned 0.051 ng/mL, and cardiology was requested.

Ischemia

Ischemia Stenosis Chest Pain Coronary Artery Disease

A man in his 30s with cardiac arrest and STE on the post-ROSC ECG

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). CT angiogram showed extensive saddle pulmonary embolism.

Cardiac Arrest

Cardiac Arrest Chest Pain Embolism Pulmonary

An undergraduate who is an EKG tech sees something. The computer calls it completely normal. How about the physicians?

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?

Chest Pain

Chest Pain Blood Pressure Ischemia STEMI

New Guidelines on Peripheral Artery Disease Issued by American Heart Association, American College of Cardiology and Leading Medical Societies

DAIC

MAY 16, 2024

PAD is a serious, progressive cardiovascular disease primarily caused by a buildup of fatty plaque in the blood vessels, or atherosclerosis. This plaque narrows the blood vessels and reduces blood flow to the legs and feet, which may significantly impair physical function, walking performance and quality of life.

Peripheral Arterial Disease

Peripheral Arterial Disease Exercise Quality of Life Ischemia

1 hour of CPR, then ECMO circulation, then successful defibrillation.

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. Here is my comment on MINOCA: "Non-obstructive coronary disease" does not necessarily imply "no plaque rupture with thrombus." They often cannot even be recognized as culprits, as fissured or ulcerated plaque. myocarditis).

Defibrillator

Defibrillator Circulation Plaque Cardiac Arrest

A 30-something woman with intermittent CP, a HEART score of 2 and a Negative CT Coronary Angiogram on the same day

Dr. Smith's ECG Blog

MAY 10, 2023

LAD plaque with 0-25 percent stenosis. No signs for aortic dissection or pulmonary embolus. --"Results were discussed with the ordering physician. If there are T-wave inversions and elevated trops in the context of persistent pain, think of other pathologies such as pulmonary embolism. A CT Coronary angiogram was ordered.

Coronary Angiogram

Coronary Angiogram Chest Pain Stenosis STEMI

A teenager with chest pain, a troponin below the limit of detection, and "benign early repolarization"

Dr. Smith's ECG Blog

JANUARY 9, 2023

CT angiogram chest: no aortic dissection or pulmonary embolism. Serial chest xrays: progressive bilateral pulmonary edema. Only after her troponin peaked at 500,000 ng/L did she get her angiogram, which showed a 100% left main occlusion due to ruptured plaque. No further troponins were measured.

Chest Pain

Chest Pain Aneurysm STEMI Thrombosis

Teenager with chest pain and slightly elevated troponin. What happens then?

Dr. Smith's ECG Blog

DECEMBER 10, 2019

He was seen at another hospital and found to have a slightly elevated troponin, then underwent a CT pulmonary angiogram (PE) protocol which revealed a right sided pneumonia. But young people do have MI, due to anomalous coronary arteries, coronary artery dissection, Kawasaki dz, even atherosclerotic plaque rupture, and other etiologies.

Chest Pain

Chest Pain Pericarditis Ischemia Pediatrics

Atherosclerotic Coronary Plaque Features in Patients with Chronic Obstructive Pulmonary Disease and Acute Coronary Syndrome

A 40-something woman with acute pulmonary edema -- see the Speckle Tracking echocardiogram.

Avocados for the Heart; Cardiology's Sad State; CBD for Pulmonary Hypertension?

Understanding an Enlarged Heart (Cardiomegaly): Causes, Symptoms, and Treatment

ECG with Aslanger's Pattern. CT Pulmonary Angiogram Reveals LAD Ischemia (Septal Transmural). But this is not Contradictory.

Understanding Coronary Circulation: The Steps that Keep Your Heart Pumping

Elder Male with Syncope

A man in his 30s with cardiac arrest and STE on the post-ROSC ECG

An undergraduate who is an EKG tech sees something. The computer calls it completely normal. How about the physicians?

New Guidelines on Peripheral Artery Disease Issued by American Heart Association, American College of Cardiology and Leading Medical Societies

1 hour of CPR, then ECMO circulation, then successful defibrillation.

A 30-something woman with intermittent CP, a HEART score of 2 and a Negative CT Coronary Angiogram on the same day

A teenager with chest pain, a troponin below the limit of detection, and "benign early repolarization"

Teenager with chest pain and slightly elevated troponin. What happens then?

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