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VF arrest at home, no memory of chest pain. Angiography non-diagnostic. Does this patient need an ICD? You need all the ECGs to know for sure.

Dr. Smith's ECG Blog

The patient was treated as possible NSTEMI and underwent coronary angiography about 4 hours after presentation. TIMI 3 means the rate of passage of dye through the coronary artery is normal by angiography.) Given the presentation, the cardiologist stented the vessel and the patient returned to the ICU for ongoing critical care.

Coronary 118
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"Pericarditis" strikes again

Dr. Smith's ECG Blog

They found non-obstructive CAD, with only a 20% stenosis of OM2 and 10% RCA. in the ICU but survived with excellent function. A repeat ECG was performed and cardiology was re-consulted: Roughly unchanged. With the troponin elevated and ongoing pain, cardiology now decided to take him to the lab. No acute culprit.

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What will you do for this patient transferred to you who is now asymptomatic?

Dr. Smith's ECG Blog

She also had non-acute CAD of the left main (50%) and LCX (75%). If for some reason the angiogram is delayed, they should receive maximal medical therapy in an ICU setting with continuous 12-lead ST segment monitoring under the close attention of a practitioner with advanced ECG interpretation training. They opened it. Blondheim et al.

STEMI 52
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A dialysis patient with nonspecific symptoms and pseudonormalization of ST segments

Dr. Smith's ECG Blog

Fortunately, he was extubated several days later in the ICU with intact baseline mental status and was discharged shortly thereafter to subacute rehab. In this study of dialysis patients with severe CAD, 77% had an abnormal resting EKG and the most common abnormality was LVH. His troponin I peaked at 97 ng/mL (very large MI!).

CAD 52