CAD Coronary Information 
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. A CT Coronary angiogram was ordered. Here are the results: --Minimally obstructive coronary artery disease. --LAD
EM Literature of Note
OCTOBER 18, 2021
Pervasive use of CT coronary angiography has been an unnecessary feature of the evaluation of patient with low-risk chest pain for the better part of a decade now. Patients were eligible by symptoms of an acute coronary syndrome, supported by ECG changes, an elevated troponin, or a history of ischemic heart disease.
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OntarioMedic
FEBRUARY 8, 2018
In this category, most cases are a result of end-stage coronary artery disease, either with a history of myocardial infarction or with a chronically underperfused, yet viable, myocardium. Q waves in contiguous leads strongly implicate a previous myocardial infarction and coronary artery disease as the cause. Currently, 5.7
Dr. Smith's ECG Blog
JANUARY 9, 2023
No family history of sudden cardiac death, cardiomyopathy, premature CAD, or other cardiac issues. This was sent to me with no information and I immediately replied that it was diagnostic of LAD OMI. I sent this ECG to Dr. Smith, with the only information that it is a 17 year old with chest pain.
Dr. Smith's ECG Blog
NOVEMBER 30, 2022
Hospital Course The patient was taken emergently to the cath lab which did not reveal any significant coronary artery disease, but she was noted to have reduced EF consistent with Takotsubo cardiomyopathy. Just because you don't see hemodynamically significant CAD on angiogram does not mean it is not OMI. It can only be seen by IVUS.
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. Next day, t he patient was taken for an angiogram and found to have a reperfused LAD lesion with good flow that appeared to the angiographer as if it was a spontaneous coronary artery dissection.
Dr. Smith's ECG Blog
JUNE 18, 2013
I want all to know that, with the right mind preparation, and the use of the early repol/LAD occlusion formula, extremely subtle coronary occlusion can be detected prospectively, with no other information than the ECG. It is not a missed STEMI, but it is a missed coronary occlusion. Wang T, Zhang M, Fu Y, et al.
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