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I would like to share with you this case I saw in Nashville a couple of days ago..

A 47-year-old Hispanic lady, presented to the Emergency department (ED) with chest pain while climbing the stairs. The pain lasted for 45 min before arrival to ED.

Her presenting EKG is shown here.

What is the interpretation of the EKG, and what we do next?

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Reposted Fathi Idris's post.

I would like to share this interesting case from couple of days ago.

A 63-year-old African American lady with acute coronary syndrome. During her catheterization, when injecting the left main coronary artery, the catheter slid and jumped into another vessel. That turned out to be the RCA originating just very close to the left main. A repeat cranial view, (angiogram 2.) Clarifies the relationship between to the separate ostia in the left coronary cusp.

CX was occluded and RCA has two proximal tandem lesions.

We elected to perform intervention on both vessels. Finding a guide catheter for the apparent RCA was a bit challenging, however we used a JR4 guide catheter but needed to engage the ostium with an interventional wire of the cusp and then advanced the JR4 guide catheter to the ostium of the aberrant RCA. The rest was straight forward.

I wonder, if we did not luckily jump in to the RCA from the left coronary cusp injection, we could have wasted long time trying to search for the RCA on the right coronary cusp. Rare anomaly, but keep it in mind!

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Reposted Khalid Abozguia's post.

Recap of HRS23 in NOLA: No significant advancements in clinical trials were reported. However, there was considerable focus on three notable areas of interest: left bundle area pacing, CardioNeuroAblation, and PulseField Ablation.

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Reposted Khalid Abozguia's post.

Recap of HRS23 in NOLA: No significant advancements in clinical trials were reported. However, there was considerable focus on three notable areas of interest: left bundle area pacing, CardioNeuroAblation, and PulseField Ablation.

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Reposted Khalid Abozguia's post.

Cardio Neuro Ablation (CNA) for syncope in young patient- another exciting groundbreaking technique discussed at #HRS23 @NOLA

early days but promising data

need more RCT

what do you think?

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Reposted Khalid Abozguia's post.

Meeting the master of Cardio Neuro Ablation (CNA) #HRS23 @NOLA

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I want to share this "routine" case we see everyday, but it has a little twist that we don't see very often. No tricks here!!

This is a 41-y-o Hispanic male, presented with lingering CP x 12 hrs. Exam negative.

Presenting EKG below:

Troponins below:

Did well overnight. No recurrent CP.

What's next: Stress or Cath?

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Reposted Fathi Idris's post.

This is a 41-year-old African American male referred because of abnormal EKG that was noticed during an ER visit for uncontrolled hypertension.

He denies chest pain, palpitation, shortness of breath, syncope or any other symptoms. He has a recent echocardiogram shows LVH, otherwise It is unremarkable.

His job is a social worker.

What is wrong with his EKG? and what is the next step of management? (answer the poll below)

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Reposted Fathi Idris's post.

This is a 37-year-old female who was seen in the ER for left lower abdominal pain.

While in the ER sleeping, the following rhythm strip was noticed. The ER provider ordered stat magnesium, cardiac troponins, EKG, which was within normal limits.

 What would you do next?

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Reposted Fathi Idris's discussion.

Would like to share this case from last week. It is an acute MI but with a couple of twists in presentation that I thought worth sharing.

A 61 year-old-male with family h/o CAD. Presented to ED with 30 min of left sided chest pain radiates to the left shoulder. EKG on arrival shown.

Initial hs-cTnT: 7 and 1-hr later was 11 (normal NTG lowered CP from 10/10 to 4/10, morphine helped as well.

Repeat hs-cTnT at 3-hr is: 41. EKG 2 hours later shown:

The patient was taken to the Cath lab and found to have a coronary lesion.  Where is that lesion?

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A 73 year old male patient with history of cardiomyopathy and complete heart block s/p biV ICD. He was recently seen by a cardiologist and had a programming change made since he has been complaining of dyspnea on exertion and some dizziness. EKG is shown.

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Reposted Fathi Idris's post.

A 48-year-old male post-PCI to LAD. He reports 2/10 chest pain, otherwise hemodynamically stable. 

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