ACS CAD Definition 
EMS 12-Lead
APRIL 9, 2024
Many of the changes seen are reminiscent of LVH with “strain,” and downstream Echo may very well corroborate such a suspicion, but since the ECG isn’t the best tool for definitively establishing the presence of LVH, we must favor a subendocardial ischemia pattern, instead. This was deemed “non-specific” by the ED physicians. Type I ischemia.
EMS 12-Lead
JULY 24, 2023
Category 1 : Sudden narrowing of a coronary artery due to ACS (plaque rupture with thrombosis and/or downstream showering of platelet-fibrin aggregates. Smith : This is ACS even if the troponin returns normal, and the first troponin especially might return normal. It is accelerated angina, which is by definition not stable.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Dr. Smith's ECG Blog
APRIL 9, 2024
By Magnus Nossen This ECG is from a young man with no risk factors for CAD, he presented with chest pain. ACS then becomes less likely. Before the lab values returned this patient had a n emergent coronary CT angiogram done that ruled out CAD. How would you assess this ECG? How confident are you in your assessment?
Dr. Smith's ECG Blog
NOVEMBER 3, 2023
A man in his 70s with past medical history of hypertension, dyslipidemia, CAD s/p left circumflex stent 2 years prior presented to the ED with worsening intermittent exertional chest pain relieved by rest. In our opinion it should not be given in ACS unless you are committed to the cath lab.
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 11, 2019
He also had non-acute CAD of the RCA (50%) and LCX (50%). B OTTOM L ine : While ECG #1 does not satisfy the definition of a STEMI — as per Dr. Meyers, it really looks like a cute L AD O MI. Meyers : This ECG was texted to me with no clinical information, and my response was: "That looks like a very subtle LAD OMI.
Dr. Smith's ECG Blog
NOVEMBER 30, 2022
The fire department, who operate at an EMT level in this municipality, arrived before us and administered 324 mg of baby aspirin to the patient due to concern for ACS. Just because you don't see hemodynamically significant CAD on angiogram does not mean it is not OMI. I could have told you this (and did tell you this) without an MRI.
Expert insights. Personalized for you.
290 
Let's personalize your content