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The patient was discharged with a diagnosis of acute pericarditis — and treated with a full course of colchicine and ibuprofen. The ultimate discharge diagnosis was acute pericarditis. ( From the information provided — I would not make the diagnosis of acute pericarditis. Figure-1: The initial ECG in today's case.
Overall, this looks like one of the rare ECGs that is actually specific for pericarditis in my opinion. QOH versions 1 and 2 both say Not OMI, with high confidence, without any clinical context, despite the abnormal STE meeting STEMI criteria. Pericarditis maybe." There was no prior ECG for comparison.
06:44 - T-waves in V2 are smaller now - Overall resolution of prior findings (which qualifies as a dynamic change) The initial note by the cardiologist states that the presentation is more consistent with pericarditis. Remember, pericarditis is the thing you say and write down when youre actively trying to miss an OMI.
Recall from this post referencing this study that "reciprocal STD in aVL is highly sensitive for inferior OMI (far better than STEMI criteria) and excludes pericarditis, but is not specific for OMI." 2014 AHA/ACC guideline for the management of patients with non–ST-elevation acute coronary syndromes. The case continues.
There is a reasonable chance of pericarditis in this case, or this could be a baseline." Here is the Queen of Heart's interpretation: The cath lab had been activated for concern of STEMI. Sadly, I did not receive enough information to adjudicate whether this patient has pericarditis or not. I immediately responded: "cool fake!
It could also be due to pericarditis or myocarditis, but I always say that "you diagnose pericarditis at your peril." The clinical presentation is very suggestive of myo-pericarditis. But one should always remember that acute MI is a far more common pathology than myo- or pericarditis. Pericarditis? 13, 2019 Dr.
You do NOT see this in normal variant STE, nor in pericarditis. Here is data from a study we published in 2014 for type II NonSTEMI: Sandoval Y. Here is the computer interpretation: (Veritas algorithm) This is what I said: "This is diagnostic of an acute inferior MI. First was 2.9 ng/mL and subsequentle dropped to 1.5 Murakami M.
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