ACS Ambulance Coronary 
Dr. Smith's ECG Blog
NOVEMBER 15, 2023
She was brought in by ambulance and received aspirin and nitroglycerin en route. Angiogram No obstructive epicardial coronary artery disease Cannot exclude non-ACS causes of troponin elevation including coronary vasospasm, stress cardiomyopathy, microvascular disease, etc. This originally radiated into her left arm.
Dr. Smith's ECG Blog
DECEMBER 19, 2023
The ambulance report says "BP continued to drop during transport and pt remained cold and clammy." Frick — an all-too-common misconception is that the absence of obstructive coronary disease on cardiac catheterization rules out acute coronary occlusion as the cause of the patient's acute event. This is not the case.
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Dr. Smith's ECG Blog
APRIL 20, 2018
The nitro she took in the ambulance did not help. If she had no risk factors, it is doubtful that she would have developed such extensive coronary artery disease as we see on the angiogram. Patients like her are the reason we are advocating for a change in the ACS paradigm from STEMI to OMI.
Dr. Smith's ECG Blog
OCTOBER 20, 2024
His wife contacted the ambulance service after the patient experienced an episode of loss of consciousness. The ST segment changes are compatible with severe subendocardial ischemia which can be caused by type I MI from ACS or potentially from type II MI (non-obstructive coronary artery disease with supply/demand mismatch).
REBEL EM
MARCH 2, 2023
Background: Historically, we have treated acute coronary syndrome with supplemental oxygen regardless of the patient ’ s oxygen saturation. More recent evidence, however, demonstrates that too much oxygen could be harmful ( AVOID Trial ) by causing coronary vasoconstriction and increasing oxidative stress. Low O2 protocol: 3.1%
EMS 12-Lead
JUNE 1, 2022
Such findings would normally suggest primary ischemia with concomitant surveillance of coronary occlusion, but these ST/T changes might very well be secondary to the Escape mechanism at hand. Evaluation of T-wave morphology in patients with left bundle branch block and suspected acute coronary syndrome. 3] Meyers, H. 4] Dodd, K.
Dr. Smith's ECG Blog
JUNE 17, 2024
Written by Bobby Nicholson, MD 67 year old male with history of hypertension and hyperlipidemia presented to the Emergency Department via ambulance with midsternal nonradiating chest pain and dyspnea on exertion. looked at consecutive patients with PE, ACS, or neither. What do you think? ng/mL, BNP 2790, and lactate 3.7. Kosuge et al.
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