EMS 12-Lead

APRIL 9, 2024

Sudden narrowing of a coronary artery due to ACS (plaque rupture with thrombosis and/or downstream showering of platelet-fibrin aggregates). The underlying etiology is either Type 1 or Type II ischemia, although sometimes there’s overlap of both. Type I ischemia. Type II ischemia.

Ischemia 116

Ischemia Stenosis Chest Pain Coronary Artery Disease 116

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!! One of the most common is rupture of a non-obstructive plaque, with thrombus formation and OMI that spontaneously lyses and leaves a wide open artery. It can only be seen by IVUS.

Plaque 52

Plaque Chest Pain Thrombosis Stenosis 52

Dr. S. Venkatesan MD

JANUARY 14, 2024

How common is thrombosis in the culprit artery of Wellen syndrome ? It is generally believed it is more of a mechanical plaque lesion. However by no means, we can say thrombosis do not occur. RCA and LCX Wellens do occur, making this entity’s perceived unique importance less certain 3.

Anatomy 52

Anatomy Angina STEMI Thrombosis 52

Dr. Smith's ECG Blog

SEPTEMBER 9, 2024

Smith comment : a very high proportion of MINOCA are ruptured plaque with lysed thrombus. That plaque is at risk of thrombosing again. It is worthwhile remembering that the majority of plaques which rupture are non-obstructive before they ulcerate and thrombose. Most plaque is outside the lumen!!

Plaque 66

Plaque Stents Stent Chest Pain 66

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 52

Pulmonary Hypertension AFIB COVID-19 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. 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. FFR can be useful.

Defibrillator 52

Defibrillator Circulation Plaque Cardiac Arrest 52

DAIC

JANUARY 23, 2024

Atherosclerotic cardiovascular disease (ASCVD), caused by plaque buildup in arterial walls, is one of the leading causes of disability and death worldwide.1,2 7 Research has shown inflammation plays a significant role in the development of atherosclerosis and ASCVD,8-10 and even the formation of plaque.11 4 In the U.S.

Cardiovascular Disease 111

Cardiovascular Disease Heart Attack Heart attacks Coronary Artery Disease 111

EMS 12-Lead

JULY 24, 2023

Category 1 : Sudden narrowing of a coronary artery due to ACS (plaque rupture with thrombosis and/or downstream showering of platelet-fibrin aggregates. elevated BP), but rather directly correlated with coronary obstruction (due to plaque rupture and thrombosis) and, potentially, stymied TIMI flow. Severe Hypoxia b.

Angina 52

Angina Ischemia Coronary Angiogram Stenosis 52

Cardiology Update

APRIL 9, 2024

The primary non-inferiority endpoint was MACCE (a composite of cardiac death, MI, ischaemic stroke, stent thrombosis, or target vessel revascularisation). These patients were identified to have non-flow-limiting vulnerable coronary plaques through intracoronary imaging.

Angina 52

Angina Myocardial Infarction Aortic valve Coronary Artery Disease 52

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

IHC revealed beta‐amyloid plaques in the parenchyma and vessel walls, confirming a diagnosis of CAA.ConclusionApparently cryptogenic lobar hemorrhage may be caused by both occult micro‐AVM/fistula and CAA. A repeat 6‐vessel DSA was again unremarkable as was repeat brain MRI.

Hemorrhage 40

Hemorrhage AFIB Cerebrovascular Disease Thrombosis 40

Dr. Smith's ECG Blog

JANUARY 9, 2023

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. Young people can suffer acute coronary occlusion, whether by typical atherosclerotic plaque rupture, or by coronary anomalies, coronary aneurysms, dissections, spasm, etc. Diagnostic of Massive OMI.

Chest Pain 52

Chest Pain Aneurysm STEMI Thrombosis 52

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. The reappearance of de Winter's pattern caused by acute stent thrombosis: A case report. Then, the patients third ECG showed a very rare combination of de Winter T waves happening during LBBB. Am J Emerg Med.

Chest Pain 83

Chest Pain Cardiogenic Shock Ischemia Myocardial Infarction 83

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

Widespread ST-depression with reciprocal aVR ST-elevation can be cause by: Heart rate related: tachyarrhythmia (e.g.,

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52

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).

Cardiac Arrest 52

Cardiac Arrest Chest Pain Embolism Pulmonary 52

Stroke Journal

JANUARY 21, 2024

BACKGROUND:Sex-specific differences in plaque composition and instability underscore the need to explore circulating markers for better prediction of high-risk plaques. Plaque stability was determined by gold-standard histological classifications. Adipokine, lipid, and immune profiling was conducted.

Plaque 40

Plaque Circulation Atherosclerosis Hemorrhage 40

Dr. Smith's ECG Blog

MARCH 8, 2025

Angiography was technically challenging as the patient was receiving CPR, but the cardiologist suspected acute stent thrombosis and initiated cangrelor, although no repeat angiography was able to be obtained. Mechanisms of plaque formation and rupture. Coronary plaque disruption. She was defibrillated perhaps 25 times.

Cardiomyopathy 75

Cardiomyopathy Myocardial Infarction Defibrillator Bradycardia 75

Dr. Smith's ECG Blog

JANUARY 21, 2025

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". Most MINOCA is due to ruptured plaque with thrombus that lyses and does not leave behind a visible culprit. So there is a new inferior severe wall motion abnormality. The dye don't lie".except

Chest Pain 62

Chest Pain STEMI Tachycardia Myocardial Infarction 62