Dr. Smith's ECG Blog

JANUARY 5, 2024

The LAD has diffuse disease with a few areas of moderate stenosis but no flow-limiting lesions. On intravascular ultrasound (IVUS), the mid RCA plaque was described as "cratered, inflamed, and bulky," and the OM plaque was described as "bulky with evidence of inflammation and probably ulceration."

Angina 121

Angina Plaque Document Stents 121

Dr. Smith's ECG Blog

MAY 13, 2024

The Queen of Hearts read this ECG as OMI – Low Confidence Click here to sign up for QoH Access The providers taking care of this patient were concerned regarding his clinical history and initial ECG, so they next performed a bedside cardiac ultrasound. The culprit mid LAD lesion was stented.

Chest Pain 120

Chest Pain STEMI Ultrasound Heart Attack 120

Circulation

NOVEMBER 11, 2024

The left circumflex had 80% proximal stenosis with minimal luminal irregularities in the mid to distal portion. After guidewire crossing, balloon angioplasty was performed, and a drug-eluting stent was deployed. An intravascular ultrasound was also performed, which was negative for vessel dissection.

Coronary Artery Disease 40

Coronary Artery Disease Angioplasty Anatomy Angina 40

Dr. Smith's ECG Blog

SEPTEMBER 9, 2024

The cardiologist called this 20% stenosis. Fortunately, this operator used intravascular ultrasound (IVUS). The operator documented thoughtful consideration of risks and benefits of stent placement. However, given the context, she returned for immediate angiography and received a stent to her proximal LAD.

Plaque 66

Plaque Stents Stent Chest Pain 66

Dr. Anish Koka

JULY 23, 2023

A lower extremity arterial ultrasound revealed elevated velocities in the right proximal superficial femoral artery. Dr. Dormu performed an aortogram of the bilateral lower extremity with bilateral iliac runoff, which revealed a 90% stenosis of the right superficial femoral artery and 100% occlusion of all three tibial vessels.

Vascular Care 52

Vascular Care Outpatient Peripheral Arterial Disease Stent 52

Dr. Smith's ECG Blog

DECEMBER 19, 2023

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. The image on the left shows the LAD before intervention, and the red circled portion on the right indicates the stented region.

Plaque 127

Plaque Angina Blog Stents 127

Dr. Smith's ECG Blog

SEPTEMBER 4, 2016

It was opened and stented. There was an old ECG for comparison: One year prior with no ST segment abnormalities A bedside cardiac ultrasound was done by the emergency physician. LM: No significant stenosis. LAD: luminal irregularities with a 40% stenosis at the take-off of a D3. D3 has a 95% tubular ostial stenosis.

Ischemia 40

Ischemia Chest Pain STEMI Stenosis 40

Dr. Smith's ECG Blog

SEPTEMBER 16, 2015

A middle-aged male with h/o CAD and stents presented with typical chest pressure. A bedside ultrasound was done by the emergency physician, using Speckle Tracking. RBBB does not affect wall motion by dyssynchrony in the way that LBBB does. --Is there likely to be fixed coronary stenosis that led to demand ischemia during pneumonia? --Was

STEMI 40

STEMI Chest Pain Cardiac Arrest Stents 40

Dr. Smith's ECG Blog

MARCH 28, 2017

Here are a couple shots with strain, or "speckle tracking" on ED Echo: To, me these look like anterior wall motion abnormality, but I showed them to one of our ultrasound fellows who is very interested in this. It was stented. They read it as normal. She said: This is a tough one. Learning Points : 1. Use the 4-variable formula!!

STEMI 40

STEMI Risk Factors Bicuspid/Mitral Ultrasound 40

Dr. Smith's ECG Blog

NOVEMBER 3, 2017

Angiogram showed a critical LAD thrombotic stenosis. The patient went to cath and had a distal LAD 99% stenosis with thrombus and TIMI-2 flow. After many hours, the decided that it was appropriate to do an angiogram and they found a distal LAD occlusion which was opened and stented. It was stented. He underwent CABG.

Chest Pain 52

Chest Pain STEMI Bradycardia Stenosis 52

Dr. Smith's ECG Blog

OCTOBER 23, 2022

To, me these look like anterior wall motion abnormality, but I showed them to one of our ultrasound fellows who is very interested in this. She was treated medically for NonSTEMI, pending next day cath, which showed ulcerated plaque and a 60% thrombotic stenosis in the LAD distal to the first diagonal. It was stented.

STEMI 40

STEMI Chest Pain Hospital Risk Factors 40

Dr. Smith's ECG Blog

OCTOBER 7, 2019

They did not have an ultrasound on the ambulance (some local crews are starting to utilize POC limited US in our service areas). He was taken to the cath lab and underwent emergent intervention: Thrombotic stenosis of the proximal RCA (95% with evidence of plaque rupture) is the culprit for the patient's inferoposterior STEMI.

Bradycardia 40

Bradycardia Cardiogenic Shock STEMI Ischemia 40

Frontiers in Cardiovascular Medicine

MARCH 5, 2025

BackgroundPercutaneous coronary intervention (PCI) through the aorto-ostial coronary stent that is protruding into the aorta remains a technical challenge because of the poor coaxial alignment of the guiding catheter and the inability to advance the guidewire into the distal vessel through the stent's central lumen.

Stents 52

Stents Stent Chest Pain Myocardial Infarction 52