Remove Plaque Remove Stenosis Remove Thrombolysis
article thumbnail

Chest pain, resolved. Does it need emergent cath lab activation (some controversy here)? And much much more.

Dr. Smith's ECG Blog

A comparison of electrocardiographic changes during reperfusion of acute myocardial infarction by thrombolysis or percutaneous transluminal coronary angioplasty. Angiography : --Culprit for the patient's unstable angina/Wellen syndrome is a ruptured plaque in the mid LAD. --As Am Heart J. 2000;139:430–436.

article thumbnail

Concerning EKG with a Non-obstructive angiogram. What happened?

Dr. Smith's ECG Blog

link] A 62 year old man with a history of hypertension, type 2 diabetes mellitus, and carotid artery stenosis called 911 at 9:30 in the morning with complaint of chest pain. Smith's comments in the May 19, 2020 post : — Non-obstructive coronary disease does not ne cessarily imply no plaque rupture with thrombus.

Plaque 127
article thumbnail

Abstract 4119169: Navigating Complexity: The Carlino Technique in Multivessel Percutaneous Coronary Intervention for Chronic Total Occlusion

Circulation

She was diagnosed with NSTEMI with a thrombolysis in myocardial infarction (TIMI) score of 5. PCI, particularly with the Carlino technique, offers a reliable approach.

article thumbnail

A man in his 50s with acute chest pain and LVH

Dr. Smith's ECG Blog

Cath at approximately 0945: "The LAD had a 90% proximal stenosis with TIMI 3 flow which corresponds to his ECG although LV function remains preserved. With nitroglycerin there is improvement in the 90% stenosis but still persistent stenosis consistent with the dynamic nature of his presentation.

article thumbnail

90 year old with acute chest and epigastric pain, and diffuse ST depression with reciprocal STE in aVR: activate the cath lab?

Dr. Smith's ECG Blog

This has been termed a “STEMI equivalent” and included in STEMI guidelines, suggesting this patient should receive dual anti-platelets, heparin and immediate cath lab activation–or thrombolysis in centres where cath lab is not available. 2 cases of Aortic Stenosis: Diffuse Subendocardial Ischemia on the ECG. Anything more on history?

article thumbnail

A woman in her 30s with sudden chest pain, nausea, and diaphoresis. Was her cardiology management appropriate?

Dr. Smith's ECG Blog

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). Normal RV function.