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I am interventional Cardiologist 🫀.I will share all kind of information about interventional cardiology like STEMI management primary PCI,Coronary interventions ,PCI, Pacemaker, AICD, CRT-D/P,Device Closure & Others and tips & tricks.

A 40-year-old man presents to the emergency department with severe substernal chest pain that awakened him from sleep. H...
26/08/2026

A 40-year-old man presents to the emergency department with severe substernal chest pain that awakened him from sleep. He smokes one pack of ci******es per day. On examination his blood pressure is 136/84 mm Hg, heart rate is 98 bpm, and his cardiac examination is otherwise unremarkable. His electrocardiogram shows ST segment elevation in leads V1-V3. His troponin T is 0.04 ng/ml. Coronary angiography is notable for the following images

What is the Angiography diagnosis?

The most common pathophysiologic mechanism for NSTEMI is disruption of the fibrous cap (plaque rupture or erosion), whic...
26/08/2026

The most common pathophysiologic mechanism for NSTEMI is disruption of the fibrous cap (plaque rupture or erosion), which stimulates thrombogenesis (Figure 1). The progression of plaque formation begins with extracellular lipid accumulation in the subintima (stage 2) and progresses to the fibrofatty stage (stage 3) followed by procoagulant expression and weakening of the fibrous cap (stage 4). Acute coronary syndrome occurs at the time of
disruption of the fibrous cap and superimposed thrombus formation (stage 5). Following thrombus reabsorption, there is collagen accumulation and smooth muscle cell growth (stage
6).

The TIMI risk score is determined by the sum of the presence of seven variables at admission; one point is given for eac...
26/08/2026

The TIMI risk score is determined by the sum of the presence of seven variables at admission; one point is given for each of the following variables: ≥65 years of age; three or more risk factors for coronary artery disease; prior coronary stenosis ≥50%; ST deviation on electrocardiography; two or more anginal events in the prior 24 hours; use of aspirin in the prior 7 days; and elevated cardiac biomarkers. The TIMI risk score may be useful in predicting 30-day and 1-year mortality in patients with non–ST-elevation acute coronary syndromes.

High-risk features based on the Thrombolysis in Myocardial Infarction (TIMI) risk score. The TIMI risk score includes th...
25/08/2026

High-risk features based on the Thrombolysis in Myocardial Infarction (TIMI) risk score. The TIMI risk score includes the following criteria:
Age >65 years,
Multiple risk factors for coronary heart disease,
ST-segment deviation on admission ECG,
Multiple episodes of angina in the preceding 24 hours,
Aspirin use in the prior 7 days, elevated serum cardiac biomarkers, and prior/known coronary stenosis ≥50%.
Patients with 0-2 of these features are considered low risk, patients with 3-4 are intermediate risk, and patients with 5-7, are at high risk for all-cause mortality, myocardial infarction, and/or severe
recurrent angina requiring urgent revascularization, as seen in the TIMI 11B (Thrombolysis In Myocardial Ischemia trial, phase 11B) and ESSENCE (Efficacy and Safety of Subcutaneous Enoxaparin in Unstable Angina and Non-Q-wave MI) trials . These risk factors are all weighted equally in the risk score, although some features, such as elevated biomarkers and dynamic ECG changes, may have higher absolute risks and specificities for coronary ischemia.

A 66-year-old man presents to the emergency department with 3 days of intermittent substernal chest tightness. The pain ...
25/08/2026

A 66-year-old man presents to the emergency department with 3 days of intermittent substernal chest tightness. The pain occurs when he walks any distance and resolves with 10 minutes of rest. He had taken aspirin with his first episode of chest discomfort without any relief. He has smoked one pack of ci******es per day for the previous 50 years. His past medical history includes hypertension and hyperlipidemia.

What is the possible ECG diagnosis ?

A 69-year-old woman is brought to the hospital with a 1-day history of shortness of breath and chest pain. She has a pas...
25/08/2026

A 69-year-old woman is brought to the hospital with a 1-day history of shortness of breath and chest pain. She has a past medical history of hypertension, chronic renal insufficiency.

What is the ECG diagnosis?

A 68-year-old woman is seen in the emergency department with chest pain and an electrocardiogram (ECG) demonstrating an ...
25/08/2026

A 68-year-old woman is seen in the emergency department with chest pain and an electrocardiogram (ECG) demonstrating an acute ST elevation inferior wall myocardial infarction. She is treated with intravenous thrombolytics due to the community hospital's
inability to perform angioplasty and the distance from a tertiary care hospital on a stormy night. Twenty minutes after the infusion is complete, she notices relief of her pain. A wide complex rhythm is seen on telemetry and an ECG is obtained and shown below..

What is the ECG diagnosis ?
what is next step of management of this ECG diagnosis ?

Which one of the following can be associated with routine aspiration thrombectomy in ST segment elevation myocardial inf...
24/08/2026

Which one of the following can be associated with routine aspiration thrombectomy in ST segment elevation myocardial infarction (STEMI)?

A. Decreased stent thrombosis.
B. Lower mortality.
C. Decreased infarct size.
D. Increased incidence of coronary dissection.
E. Increased stroke.

24/08/2026

55-year-old man is brought to the emergency department with chest pain and ST segment elevation in leads II, III and aVF.

of the following findings on electrocardiogram (ECG) would be associated with the highest mortality risk?

A. An R wave >13 mm in lead AvL.

B. 1 mm ST depression in lead I.

C. 1 mm of ST elevation in lead V4R.

D. T wave inversions in lead V6.

E. A PR interval of 220 msec.


A 45-year-old man presents with chest pain to the emergency department. He describes leftsided discomfort that radiates ...
24/08/2026

A 45-year-old man presents with chest pain to the emergency department. He describes leftsided discomfort that radiates to his left shoulder and is worse with deep breaths. His medical history is significant for an ST-segment elevation myocardial infarction (MI) 2 weeks prior, at which time he received a drug-eluting stent to his left circumflex lesion.

What is the Diagnosis?

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