48-year-old female presented with chest pain. History of HTN, HLD, and current smoking. Troponin at 230. EKG findings as below. Thoughts?I #Cardiology #fellow #CardioTwitter #medtwitter #CardioEd #echofirst #ECG

RT @ecgandrhythmRoe: @Bandaraalyami The relative long QT (compared with the heart rate) should have directed us to this diagnosis

RT @EM_RESUS: @Bandaraalyami @argulian @ecgandrhythmRoe @DrRazi4 @ECGEPSCADEVICE @DrRajeshG1 @ecgrhythms Often times very difficult to ID a…

@DrRazi4 Thanks for your comment Dr Razi. Cath with no culprit lesion.

@sbag_in Reduced EF and negative Cath . TTS

@Ecgloverr Newly reduced EF with diffuse hypokinesia and akinetic Apex

@EM_RESUS @argulian @ecgandrhythmRoe @DrRazi4 @ECGEPSCADEVICE @DrRajeshG1 @ecgrhythms The repeated ECG showed prolonged QT and worsening T-wave inversion

@sbag_in @argulian @ecgandrhythmRoe @DrRazi4 @ECGEPSCADEVICE @EM_RESUS @DrRajeshG1 @ecgrhythms Cath revealed no OMI

@jl35wilsonMD @argulian @ecgandrhythmRoe @DrRazi4 @ECGEPSCADEVICE @EM_RESUS @DrRajeshG1 @ecgrhythms There was no OMI 👍

I agree with you, Dr. Ghali, that the ECG findings could be explained by spontaneous reperfusion of an LAD occlusion. However, after we obtained the TTE , I think the significant reduction in EF and the non-localized wall motion abnormalities may suggest an alternative explanation, as these findings are less consistent with this mechanism given the expected myocardial salvage.

@ecgandrhythmRoe @argulian @DrRazi4 @ECGEPSCADEVICE @EM_RESUS @DrRajeshG1 @ecgrhythms Thanks for your input Dr. Roeschl , All grafts were patent on LHC, with no culprit lesion

The patient has a history of severe native CAD and underwent CABG in 2015 with five bypass grafts placed. During this admission, all grafts were confirmed patent on LHC, with no culprit lesion identified to explain the EKG changes and troponin elevation. TTE revealed a newly reduced EF of 25% with new wall motion abnormalities that were not present one year ago. Diagnosis: Stress-induced cardiomyopathy

@ecgandrhythmRoe @argulian @DrRazi4 @ECGEPSCADEVICE @EM_RESUS @DrRajeshG1 @ecgrhythms Sure Dr Roeschl , this is an old EKG

Happy New Year, everyone! Wishing you a healthy, successful year ahead! #HappyNewYear2025 #MedTwitter

RT @sudarshanballa: A very interesting TEE to end 2024. Diagnosis? @WvuCvFellows @CvWvu @CASivaram1 @iamritu @dipesh_ludhwani @harshi_md #e…

@EM_RESUS Awesome presentation

RT @Bandaraalyami: A quick breakdown of #Takotsubo Cardiomyopathy (TCM) : What you need to know . Let’s review its pathophysiology, present…

@Dokutah_Vyew @argulian @ecgandrhythmRoe @DrRazi4 @ECGEPSCADEVICE @EM_RESUS @DrRajeshG1 @ekgpress Yes , Cath first 👍 There are different anatomical variants of Takotsubo cardiomyopathy, with the most common type being apical ballooning (around 80 %)

Interesting Dr Savage , When I posted the case below, I was thinking about how the hyperdynamic movement of the coronary arteries in one area, combined with minimal movement at the apex, could be used to support the diagnosis of Takotsubo cardiomyopathy—even without an LV angiogram.

@Jigarbuddhdev4 @DrRazi4 @ecgandrhythmRoe @Ecgloverr @EcgOxford @Willis_Kwandou @ZHeart11768530 @ManualOMedicine There is Upsloping ST depression in the precordial leads with Peaked anterior T waves and reciprocal subtle ST elevation in aVR. #LHC for #Reperfusion