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Traditionally used as an anti-inflammatory for pericarditis (inflammation of the lining of the heart), it has recently been shown to result in fewer major heart events in those with a recent heart attack. 2017 Dec 29;7(1):e007664. 2017 May 4;376(18):1713-1722. It is an easy win, frequently missed. J Am Heart Assoc. N Engl J Med.
The initial computer and final cardiology interpretation was a differential: “ST elevation, consider early repolarization, pericarditis, or injury.” J Electrocardiol 2017 2. Hyperacute T waves can be a useful sign of occlusion myocardialinfarction if appropriately defined. McLaren, Meyers, Smith and Chartier.
Clinical questions : Is this an occlusion myocardialinfarction and does the patient need the cath lab? CMAJ 2017 Vassallo SU, Delaney KA, Hoffman RS, et al. Prominent J waves and ventricular fibrillation caused by myocarditis and pericarditis after BNT162b2 mRNA COVID-19 vaccination. J wave syndromes.
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.
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