ACS CAD Events 
EMS 12-Lead
APRIL 9, 2024
He denied any specific prodrome of gross palpitations, however did endorse feeling quite dizzy just before the event. Given no clinical prelude of anginal (or equivalent) descriptors, prior to the acute event, risk stratification of the ECG and Troponin was pursued via Echo and nuclear Myocardial Perfusion Imaging (MPI).
The Skeptics' Guide to EM
JULY 2, 2022
Major adverse cardiac event rates in moderate-risk patients: Does prior coronary disease matter? Major adverse cardiac event rates in moderate-risk patients: Does prior coronary disease matter? If we thought about ACS, we brought them in. Date: June 30th, 2022 Reference: McGinnis et al. AEM June 2022. AEM June 2022.
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Dr. Smith's ECG Blog
MAY 20, 2024
A 63 year old man with a history of hypertension, hyperlipidemia, prediabetes, and a family history of CAD developed chest pain, shortness of breath, and diaphoresis after consuming a large meal at noon. Smith comment : Is the ACS (rupture plaque) with occlusion that is now reperfusing? Edited by Smith He also sent me this great case.
Dr. Smith's ECG Blog
APRIL 14, 2023
Sent by Anonymous, written by Pendell Meyers A man in his 60s with history of CAD and 2 prior stents presented to the ED complaining of acute heavy substernal chest pain that began while eating breakfast about an hour ago, and had been persistent since then, despite EMS administering aspirin and nitroglycerin. Pre-intervention.
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. Unfortunately — 1.5
Dr. Smith's ECG Blog
MARCH 20, 2023
Remember: these findings above are included as STEMI equivalent findings in the 2022 ACC Expert Consensus Decision Pathway on ACS Patients in the ED. Angiogram soon after (around 4 hrs after presentation) showed multi vessel CAD, with culprit lesion total occlusion of the first obtuse marginal branch (OM1), which was stented.
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!
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