2018 ACS CAD 
EMS 12-Lead
JUNE 20, 2022
Moreover, he had no pertinent medical history to report in terms of CAD, HTN, HLD, or DM, for example. Although the attending crews did not consider the ECG pathognomonic for occlusive thrombosis, they nonetheless considered the patient high-risk for ACS and implored him to reconsider. A 12 Lead ECG was recorded. 3] Aslanger, E.,
Dr. Smith's ECG Blog
APRIL 18, 2024
Similarly, if a patient with known CAD presents with refractory ischemic chest pain, the ECG barely matters: the pre-test likelihood of acute coronary occlusion is so high that they need an emergent angiogram. 1] European guidelines add "regardless of biomarkers".
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Dr. Smith's ECG Blog
OCTOBER 24, 2019
However, a smooth tapering of the mid-RCA was seen, highlighted in red below: How do we explain the MI if no sign of CAD was found? This MI wasn’t caused by a ruptured plaque of CAD - it was a coronary artery dissection of the RCA. SCAD isn’t rare, especially in women Historically SCAD had been identified in 22% of ACS cases in women.
Dr. Smith's ECG Blog
NOVEMBER 26, 2018
The axiom of "type 1 (ACS, plaque rupture) STEMIs are not tachycardic unless they are in cardiogenic shock" is not applicable outside of sinus rhythm. This case represents the same physiologic event as OMI in terms of the result on the myocardium, therefore with identical ECG features, however there may not be ACS!
Dr. Smith's ECG Blog
JULY 31, 2018
She had zero CAD risk factors. Now you have ECG and troponin evidence of ischemia, AND ventricular dysrhythmia, which means this is NOT a stable ACS. hours of substernal chest pressure. It was non-radiating and without other associated symptoms except for nausea. Here was her ECG at time zero: What do you think? Circ Cardiovasc Interv.
Dr. Smith's ECG Blog
MARCH 6, 2019
She did not receive any opioids (which would mask her pain without affecting any underlying ACS). She also had non-acute CAD of the left main (50%) and LCX (75%). American Journal of Cardiology 2018. She was asymptomatic at the time of this ECG recorded on arrival to our ED: What do you think? They opened it. Blondheim et al.
Dr. Smith's ECG Blog
OCTOBER 26, 2020
The patient was transferred immediately for angiogram which revealed no significant CAD, and no intervention was performed. Learning Points: The myocardium doesn't know the etiology of OMI (ACS, spasm, dissection, embolus, etc.), That said, ACS is by far the most common and treatable cause.
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