Dr. Michelle O'Donoghue
Cardiologist
2 Podcasts on BackTable
Dr. Michelle O'Donoghue is a cardiologist at Brigham and Women's Hospital and associate professor of medicine at Harvard Medical School in Boston, Massachusetts.
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Episode # 7 • 03 Jul 2026
ACS Guidelines Question #2
The following question refers to Section 5.2.1 of the 2025 ACS Guidelines.
A 63-year-old woman presented to the emergency room for chest pain. She described having exertional chest pain for the past two months and had an episode of severe pain after dinner 3 days ago. She went to bed and slept it off. She told her children today at a family gathering, and was immediately brought to the ED by her daughter. She has a history of hypertension and hyperlipidemia. She was asymptomatic and normotensive in the ED. Labs show a down-trending troponin and an elevated NT-proBNP but are otherwise unremarkable. Her ECG showed Q waves with ST elevation in V2-V4. She was treated with aspirin and heparin drip, and taken to the cath lab. Coronary angiogram showed complete proximal LAD occlusion with right-to-left collaterals, without significant residual disease elsewhere. She remains asymptomatic and is stable, both hemodynamically and electrically.
What is the next best step with regard to reperfusion and anti-thrombotic management?
This episode is part of our comprehensive Decipher the Guidelines Series covering the 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes.
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About
Dr. Michelle O'Donoghue is the McGillycuddy-Logue Distinguished Chair in Cardiology at Brigham and Women’s Hospital (BWH). She is also an Associate Professor of Medicine at Harvard Medical School (HMS). Dr. O’Donoghue received her medical degree from Columbia University College of Physicians and Surgeons. She completed a residency in internal medicine and a cardiology fellowship at Massachusetts General Hospital and a Master’s Degree in Public Health from Harvard. Dr. O’Donoghue is board certified in cardiovascular disease.
The author of numerous peer-reviewed publications, Dr. O’Donoghue’s research focuses on optimizing the management of acute coronary syndromes (heart attacks), the study of women and heart disease, the use of existing biomarkers for risk stratification, potential new therapeutic targets, as well as the discovery and evaluation of novel biomarkers using “omic”-based technology.
The Materials available on BackTable are provided for informational and educational purposes only and are not a substitute for the independent professional judgment of a qualified healthcare professional in diagnosing or treating patients. Any opinions, statements, or views expressed are those of the individual contributors and do not necessarily reflect those of the publisher, platform, or any affiliated organization.