Remove 2019 Remove CAD Remove Coronary
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OMI in a pediatric patient? Teenagers do get acute coronary occlusion, so don't automatically dismiss the idea.

Dr. Smith's ECG Blog

Acute coronary syndrome in a pediatric patient? He did have a family history notable for early CAD. hematological disorder like sickle cell or antiphospholipid syndome, family history of CAD or hypercholesterolemia, prior history of vasculopathies such as Kawasaki Disease, MIS-C, prior cardiac surgery, etc.)

Coronary 120
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Something Winter This Way Comes

EMS 12-Lead

Otherwise, no admission of CAD, HLD, or family history of sudden cardiac death. A second 12 Lead ECG was recorded: This is a testament to the dynamic nature of coronary thrombosis and thrombolysis. He described the pain as “nagging,” and equally not exacerbated by any kind of movement. But the lesion is still active!

STEMI 130
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A 29 year old male with chest pain, ST Elevation, and very elevated troponin T

Dr. Smith's ECG Blog

By Magnus Nossen This ECG is from a young man with no risk factors for CAD, he presented with chest pain. Before the lab values returned this patient had a n emergent coronary CT angiogram done that ruled out CAD. Each main coronary artery (LAD, RCA and LCx) are shown in separate images. There are no coronary stenoses.

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Dark Side of the Moon

EMS 12-Lead

Furthermore, there was no family history of early CAD, MI, or sudden cardiac death. Cardiology admitted him for observation with plans for next-day coronary angiogram. He reported to EMS a medical history of GERD only. The physical exam was unremarkable for diaphoresis or pallor, and he denied any episodes of vomiting. 1] Driver, B.

STEMI 130
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A young peripartum woman with Chest Pain

Dr. Smith's ECG Blog

The biphasic T wave is consistent with recent reperfusion of an occluded coronary artery supplying the inferior region. Here’s the angiogram of the RCA : No thrombus or plaque rupture in the RCA (or any coronary artery) was found. This MI wasn’t caused by a ruptured plaque of CAD - it was a coronary artery dissection of the RCA.

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Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting."

Dr. Smith's ECG Blog

Hospital Course The patient was taken emergently to the cath lab which did not reveal any significant coronary artery disease, but she was noted to have reduced EF consistent with Takotsubo cardiomyopathy. Just because you don't see hemodynamically significant CAD on angiogram does not mean it is not OMI. It can only be seen by IVUS.

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What would you do with acute chest pain and this ECG? You might see what the Queen thinks.

Dr. Smith's ECG Blog

The ED provider ordered a coronary CT scan to assess the patient for CAD. The patient was taken emergently to the cath lab for a pericardiocentesis instead of a coronary angiogram. Three months prior to this presentation, he received a pacemaker for severe bradycardia and syncope due to sinus node dysfunction.

STEMI 63