ACS CAD Information 
Dr. Smith's ECG Blog
MARCH 19, 2024
The patient presented to an outside hospital An 80yo female per triage “patient presents with chest pain, also hurts to breathe” PMH: CAD, s/p stent placement, CHF, atrial fibrillation, pacemaker (placed 1 month earlier), LBBB. This case was sent by Amandeep (Deep) Singh at Highland Hospital, part of Alameda Health System.
Dr. Smith's ECG Blog
JULY 3, 2018
Submitted and written by Alex Bracey with edits by Pendell Meyers and Steve Smith Case A 50ish year old man with a history of CAD w/ prior LAD MI s/p LAD stenting presented to the ED with chest pain similar to his prior MI, but worse. link] He was admitted to the cardiology unit for serial troponin measurements and concern for possible ACS.
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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.
Dr. Smith's ECG Blog
MAY 10, 2023
At this point, with the information above, the patient's overall clinical picture could be consistent with either reperfused OMI, or Non-OMI, since both may have absent pain and inverted T waves. CAD-RADS category 1. --No Now, with elevated troponins, Wellens' syndrome is likely. A CT Coronary angiogram was ordered.
Dr. Smith's ECG Blog
JULY 11, 2019
Meyers : This ECG was texted to me with no clinical information, and my response was: "That looks like a very subtle LAD OMI. He also had non-acute CAD of the RCA (50%) and LCX (50%). Very very subtle one. What happened?" Cath images: Before intervention. Before intervention with arrows demonstrating the area of occlusion.
Dr. Smith's ECG Blog
DECEMBER 13, 2019
Written by Pendell Meyers A man in his late 40s with several ACS risk factors presented with a chief complaint of chest pain. I texted this to Dr. Smith without any information, and this was his reply: "This could be pericarditis but probably is normal variant." Our THANKS to Dr. Meyers for presenting this informative case!
Dr. Smith's ECG Blog
JULY 31, 2018
She had zero CAD risk factors. I saw this before any other information and knew immediately that it represented an LAD occlusion. Now you have ECG and troponin evidence of ischemia, AND ventricular dysrhythmia, which means this is NOT a stable ACS. It was non-radiating and without other associated symptoms except for nausea.
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