Dr. Smith's ECG Blog

SEPTEMBER 18, 2024

Bedside cardiac ultrasound with no obvious wall motion abnormalities. Thus, it has recently become generally accepted that most plaque ruptures resulting in myocardial infarction occur in plaques that narrow the lumen diameter by 40% of the arterial cross section may be involved by plaque. He was started on nitro gtt.

Ischemia 121

Ischemia Plaque Stenosis Myocardial Infarction 121

Dr. Smith's ECG Blog

NOVEMBER 15, 2023

MINOCA may be due to: coronary spasm, coronary microvascular dysfunction, plaque disruption, spontaneous coronary thrombosis/emboli , and coronary dissection; myocardial disorders, including myocarditis, takotsubo cardiomyopathy, and other cardiomyopathies. See "Mechanisms of acute coronary syndromes related to atherosclerosis".)

Coronary Angiogram 109

Coronary Angiogram Plaque Thrombosis STEMI 109

Dr. Smith's ECG Blog

DECEMBER 19, 2023

The commonest causes of MINOCA include: atherosclerotic causes such as plaque rupture or erosion with spontaneous thrombolysis, and non-atherosclerotic causes such as coronary vasospasm (sometimes called variant angina or Prinzmetal's angina), coronary embolism or thrombosis, possibly microvascular dysfunction.

Plaque 127

Plaque Angina Blog Stent 127

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

This case was provided by Spencer Schwartz, an outstanding paramedic at Hennepin EMS who is on Hennepin EMS's specialized "P3" team, a team that receives extra training in advanced procedures such as RSI, thoracostomy, vasopressors, and prehospital ultrasound. An angiogram is a "lumenogram;" most plaque is EXTRALUMINAL!!

Plaque 52

Plaque Chest Pain Thrombosis Stenosis 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 Stent Stents Chest Pain 66

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. What is Type 2 MI?

Defibrillator 52

Defibrillator Circulation Plaque Cardiac Arrest 52

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