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To Emphasize: When the patient is older and presents with a history of cardiac-sounding chest pain — then acute infarction will be much more common than acute pericarditis, myocarditis, or perimyocarditis. F ollow- U p in T oday's C ASE: The patient in today's case was diagnosed as having acute myocarditis.
The second most common cause of medical cardiac tamponade is acute idiopathic pericarditis. Less common etiologies include uremia, bacterial or tubercular pericarditis, chronic idiopathic pericarditis, hemorrhage, and other causes such as autoimmune diseases, radiation, myxedema, etc. 2013 Sep;26(9):965-1012.e15.
The exception is with postinfarction pericarditis , in which a completed transmural infarct results in inflammation of the subepicardial myocardium and STE in the distribution of the infarct, and which results in increased STE and large upright T-waves. These findings together are more commonly seen with pericarditis.
Although this is not a common phenomenon You will see it on occasion ( See the June 30, 2023 post the November 27, 2023 post and the July 24, 2013 post in Dr. Smith's ECG Blog ). Smith : I recognize this as a STEMI mimic. I was not alarmed. The providers showed me the ECG and I told them that I thought it was a fake.
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