Dr. Smith's ECG Blog

NOVEMBER 17, 2023

It is of an elderly woman who complained of shortness of breath and had a recent stent placed. Ken (below) is appropriately worried about pulmonary embolism from the ECG. What I had not told him before he made that judgement is that the patient also had ultrasound B-lines of pulmonary edema. What do you think?

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Aneurysm Stents Stent Chest Pain 123

Medical Xpress - Cardiology

FEBRUARY 22, 2024

Treatment for infants who have severe pulmonary arterial hypertension (PAH) is sometimes limited. Because they haven't physically matured, a procedure could increase the risk of serious complications, including failure of the heart's right ventricle.

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Pulmonary Hypertension Stents Stent 40

Circulation: Cardiovascular Interventions

NOVEMBER 5, 2024

BACKGROUND:Covered stent correction (CSC) of a superior sinus venosus atrial septal defect is an alternative to surgery in selected patients, but anatomic variation means that assessment for CSC requires a 3-dimensional anatomic understanding. Circulation: Cardiovascular Interventions, Volume 17, Issue 12 , Page e013964, December 1, 2024.

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Stents Stent Pulmonary Cardiovascular Interventions 40

ADN Center of Excellence

NOVEMBER 7, 2024

Our Interventional Cardiology Fellowship Program offers a unique opportunity for fellows to immerse themselves in high-volume centers and experience complex procedures such as angioplasties, stent placements, and Chronic Total Occlusion (CTO) interventions. Requirements This specialty requires a background in internal medicine or pediatrics.

Cancer 59

Cancer Academic Research Interventional Cardiology 59

Journal of the American Heart Association

DECEMBER 1, 2023

BackgroundThe modified Blalock‐Taussig‐Thomas shunt is the gold standard palliation for securing pulmonary blood flow in infants with ductal‐dependent pulmonary blood flow. Journal of the American Heart Association, Volume 12, Issue 23 , December 5, 2023.

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Pediatrics Stents Stent Pulmonary 40

Frontiers in Cardiovascular Medicine

JANUARY 10, 2024

The combined and matched subgroups were pulmonary artery stenting (Stent PUL ), aorta angioplasty (Plasty AO ), pulmonary artery angioplasty (Plasty PUL ), or a combination of the latter two (Plasty). The decrease of AK BW and DAP BW in the Stent PUL and Plasty PUL subgroups was not statistically significant.

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Congenital Angioplasty Congenital Heart Disease Stents 59

Frontiers in Cardiovascular Medicine

JANUARY 29, 2025

BackgroundThe VenaTech Convertible Vena Cava Filter (VTCF) is a device designed for insertion into the inferior vena cava (IVC) to prevent life-threatening pulmonary embolism (PE).

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Thrombosis Embolism Stents Stent 52

All About Cardiovascular System and Disorders

JANUARY 14, 2024

Chance of precipitating a cyanotic spell are more when pulmonary angiography is attempted through the already narrow right ventricular outflow tract. initial shunt surgery is an option to allow the pulmonary artery branches to grow in size and for a later complete repair of tetralogy of Fallot [1]. If McGoon’s ratio is below 0.8,

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Congenital Heart Disease Pulmonary Anatomy Congenital 52

Dr. Smith's ECG Blog

JANUARY 27, 2024

Old ‘NSTEMI’ A history of coronary artery disease and a stent to the same territory further increases pre-test likelihood of acute coronary occlusion, including in-stent thrombosis. The patient had a history of ‘NSTEMI’ a decade prior, with an RCA stent. Does this change your interpretation?

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Chest Pain STEMI Aneurysm Stents 116

Dr. Smith's ECG Blog

OCTOBER 6, 2024

The door to balloon time was incredibly short and there was a 100% circumflex occlusion that was opened and stented. I wonder if this patient had pulmonary disease? For more on ECG findings in pulmonary disease — Check out My Comment in the May 31, 2024 post in Dr. Smith's ECG Blog ). All intervals ( PR-QRS-QTc ) are normal.

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Hospital Chest Pain Blog Pulmonary 76

Dr. Smith's ECG Blog

MAY 20, 2024

In SCAPE (sympathetic crashing acute pulmonary edema), Emergency providers seem now to regularly give high dose NTG, but when the BP is 170/105 in a patient who is not crashing, we often fail to give something to lower afterload. __ Here are some Images: The red circle shows the LAD coursing down the anterior interventricular sulcus.

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Chest Pain Blood Pressure Ischemia STEMI 124

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

IntroductionThe 2015 American Heart Association Guidelines recommended mechanical thrombectomy with stent‐retriever devices. Compared with 2012‐2014, the 2015‐2019 cohort showed increased odds of ICH and shock while the odds of DVT, pulmonary embolism, pneumonia, and UTI were significantly lower.

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Stroke Strokes Cardiac Arrest Inpatient 40

Dr. Smith's ECG Blog

NOVEMBER 22, 2023

Xray was consistent with pulmonary vascular congestion. Previously placed stents in the LAD (multiple) and mid circumflex and patent Formal echocardiogram: Normal left ventricular size and wall thickness. Bedside echo showed no evidence of reduced EF, no signs of right heart strain, no regional wall abnormality.

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Chest Pain Ischemia Echocardiogram Myocardial Infarction 117

Dr. Smith's ECG Blog

NOVEMBER 25, 2017

On day 3 of hospitalization she underwent coronary angiography, revealing a 95% lesion in the mid-LAD which was stented. A new right bundle branch block in a sick patient with chest pain and/or shortness of breath is a worrisome finding concerning for LAD occlusion or significant pulmonary embolism.

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Chest Pain Pericarditis Embolism Stents 52

Dr. Smith's ECG Blog

FEBRUARY 18, 2012

There was some pulmonary edema. Perusal of her charts revealed that she had an LAD stent that was very close to the ostium of the circumflex. They texted me the following ECGs, which I viewed in the shade of a pine tree on a glorious sunny snowy landscape. AT&T surprised me with their reach. This is her ECG 1.5

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STEMI Ischemia Chest Pain Stents 52

Dr. Smith's ECG Blog

DECEMBER 14, 2016

The patient had been on a long drive, suggesting possible pulmonary embolism (this was unlikely given absence of tachyardia, hypoxia, or any other feature of PE), so we sent a d dimer. [We It was opened and stented with a door to balloon time of about 120 minutes (this is long for STEMI, but very short for a high risk Non STEMI).

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Chest Pain STEMI Aortic Pulmonary 52

Dr. Smith's ECG Blog

MAY 10, 2023

No signs for aortic dissection or pulmonary embolus. --"Results were discussed with the ordering physician. INTERVENTION * Successful angioplasty and stenting (drug eluting) of the mid LAD * Successful angioplasty of the ostial 1st diagonal Learning points: 1. A CT Coronary angiogram was ordered. LAD plaque with 0-25 percent stenosis.

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Coronary Angiogram Chest Pain Stenosis STEMI 52

Dr. Smith's ECG Blog

SEPTEMBER 30, 2019

Slow TIMI 2 initially with brisk flow status post percutaneous coronary intervention with 18mm drug-eluting stent. A majority of patients with MAT have longstanding pulmonary disease. Rather than antiarrhythmic medication — optimizing pulmonary function is the best treatment approach. To our knowledge, the patient did well.

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Chest Pain Pulmonary ACE Inhibitor Pacemaker 52

DAIC

FEBRUARY 24, 2025

As a result, healthcare faces rising expenses from frequent emergency room visits, lengthy hospital stays, costly procedures like stent placements and bypass surgeries, as well as the long-term management of chronic conditions like heart failure (HF). These costs represent a massive portion of total health expenditures.

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Hospital Cardiovascular Disease Heart Failure Heart Attack 52

Cardiometabolic Health Congress

JULY 17, 2024

February 2024 FDA Approvals: Innovations in Cardiovascular Interventions XACT Carotid Stent System (Approved: 02/07/2024) This approval expands the indications to be used during a Transcarotid Artery Revascularization (TCAR) procedure to prevent future strokes.

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Tricuspid Open-Heart Surgery Kidney Disease Pediatrics 59

Frontiers in Cardiovascular Medicine

FEBRUARY 29, 2024

Outcome In the EVAR group, 47 patients (95.92%) were successfully implanted with overlapping stents, and 2 patients died in the perioperative period. In the TAAR group, 12 patients (92.31%) were successfully revascularized and 1 patient died in the perioperative period.

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Aortic Quality of Life Stents Stent 49

Cardiometabolic Health Congress

SEPTEMBER 13, 2024

INFINITY-SWEDEHEART Trial: This randomized controlled trial, developed by Elixir Medical, compared the DynamX® Coronary Bioadaptor System with the Resolute Onyx drug-eluting stent.

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Hypertension Cardiovascular Disease Bicuspid/Mitral Arrhythmia 59

Dr. Smith's ECG Blog

DECEMBER 22, 2022

On his physical examination, cardiac and pulmonary auscultation was completely normal. Bi-phasic scan showed no dissection or pulmonary embolism. The lesion was successfully stented. He has 40 packs-year of smoking history. There was no premature cardiovascular diseases or sudden death in his family.

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STEMI Chest Pain Myocardial Infarction Electrocardiogram 52

Dr. Smith's ECG Blog

APRIL 8, 2016

Bedside ultrasound showed no effusion and moderately decreased LV function, with B-lines of pulmonary edema. This was stented. Medics stated that he had not been taking his clopidogrel for 2 weeks. He appeared to be in shock. Here is his ED ECG: There is obvious infero-posterior STEMI. After pacing, there was no recurrence of Torsades.

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STEMI Myocardial Infarction Cardiac Arrest Arrhythmia 52

Dr. Smith's ECG Blog

AUGUST 9, 2019

Here is another proven left main occlusion in a young woman who presented with sudden pulmonary edema, had this ECG recorded, then arrested and was resuscitated after 30 minutes of CPR: This has sinus tachycardia with RBBB and LAFB, and STE in V2-V6 as well as I, aVL This pattern could just as easily be seen in LAD occlusion.

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Myocardial Infarction Ischemia STEMI Cardiogenic Shock 52

Society of Thoracic Surgeons - Research

APRIL 20, 2023

Published Research kschukar Thu, 04/20/2023 - 11:12 Recently published (2016 – present) manuscripts utilizing STS data: Adult Cardiac Surgery, General Thoracic Surgery, Congenital Heart Surgery, and Intermacs/Pedimacs.

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Research Coronary Artery Bypass Graft Aortic valve Congenital 52

Society of Thoracic Surgeons - Research

APRIL 20, 2023

Institutional Coronary Artery Bypass Case Volumes and Outcomes European Journal of Heart Failure October 2023 Makoto Mori 1 Robotic Mitral Valve Repair for Degenerative Mitral Regurgitation The Annals of Thoracic Surgery August 2023 Carlos Diaz-Castrillion 2 Volume-Failure to Rescue Relationship in Acute Type A Aortic Dissections: An Analysis of The (..)

Research 52

Research Coronary Artery Bypass Graft Aortic valve Congenital 52

Wellnest

JULY 19, 2023

A completely blocked artery is located, a wire is inserted through it, the clot is sucked, the narrowing is widened with a balloon, and then a stent (stainless steel wire mesh) is placed to maintain consistent flow. Coronary angiography is performed under local anesthesia using the right arm without any cuts.

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Heart Attack Heart attacks Blood Pressure Myocardial Infarction 52

Frontiers in Cardiovascular Medicine

MARCH 30, 2025

This study reports a rare case of concurrent AMI and pulmonary thromboembolism in a patient diagnosed with pancreatic cancer.Case presentationA 70-year-old woman presented with acute chest pain and ST-segment elevation myocardial infarction, prompting immediate percutaneous coronary intervention (PCI) with the deployment of a drug-eluting stent.

Myocardial Infarction 52

Myocardial Infarction Embolism Cancer Pulmonary 52

Frontiers in Cardiovascular Medicine

FEBRUARY 27, 2025

thoracic aortic dissection, thoracic aortic aneurysm, and/or type B intramural hematoma) as well as the presence of T1ELs or T2ELs.ResultsReoperation was more common in the T1EL group (n=4; 57%) than in the T2EL group (n=2; 29%); also, reintervention for stenting of the thoracic endovascular graft was more frequent in the T1EL group (4 vs. 1).

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Risk Factors Aortic Aneurysm Stents 52

Cardiometabolic Health Congress

JANUARY 2, 2025

August 2024 Approvals Minima Stent System (P240003) (Approval Date: August 28, 2024) The Minima Stent System is an expandable cobalt-chromium metal mesh tube to reopen blood vessels in neonates, infants, and children with Coarctation of the Aorta and Pulmonary Artery Stenosis, specifically designed to expand as younger patients grow.

Coronary Artery Disease 52

Coronary Artery Disease Stents Stent Innovation 52

Dr. Smith's ECG Blog

APRIL 6, 2025

It did not show pulmonary embolism or intra-abdominal pathology, but it did show this: See the dark area at the bottom of the image? There was no pulmonary embolism. With the severe acidosis and absence of ST elevation, they felt there was more likely to be a non-cardiac etiology of his presentation.

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Blood Pressure Cardiogenic Shock Ischemia Cardiac Arrest 110

Dr. Smith's ECG Blog

DECEMBER 3, 2024

His initial high sensitivity troponin I returned at 1300 ng/L and given that his cardiac workup was otherwise unremarkable, a CT was obtained to evaluate for pulmonary embolism and aortic aneurysm or dissection but this too was unrevealing. Also: electrical instability, pulmonary edema, or hypotension. Another EKG was also obtained.

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Catheterization Laboratory STEMI Blog Ischemia 110

Frontiers in Cardiovascular Medicine

NOVEMBER 19, 2024

In-stent thrombosis, a late complication, occurred in four patients; two of these had impaired anticoagulation, including extracorporeal membrane oxygenation (ECMO)-related causes, while the other two, who were on aspirin, had multiple stents within the shunt, one of whom experienced sudden death.

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Thrombosis Stents Stent Congenital Heart Disease 59

Dr. Smith's ECG Blog

OCTOBER 27, 2024

No pulmonary embolism is identified. First obtuse marginal also had an 80% stenosis and was stented. While in the ED, patient's pain worsened to previous severity of 6/10 pain and improved to 3/10 on NTG drip. CT Angio Chest IMPRESSION 1. No thoracic aortic hematoma, aneurysm or dissection.

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STEMI Chest Pain Myocardial Infarction Aneurysm 120