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Clinician and EKG machine read of acute pericarditis. While it is true that inferior MI has ST depression in aVL 99% of the time (Bischof and Smith), and that inferolateral ST elevation is the most common distribution for pericarditis, the ST elevation in V3 has "terminal QRS distortion (TQRSD)," (diagnostic of LAD occlusion).
PR depression, which suggests pericarditis 4. We also showed that, of 47 cases of pericarditis with ST elevation, none had ST depression in aVL. ) My Comment, by KEN GRAUER, MD ( 6/17/2018 ): = Excellent case with insightful learning points explaining why these serial tracings are not indicative of acute inferior infarction.
A bedside ultrasound should be done to assess volume and other etiologies of tachycardia, but if no cause of type 2 MI is found, the cath lab should be activated NOW. The "flu-like" illness suggests myo- or pericarditis, but that would be a diagnosis of exclusion. The January 30, 2018 post — for PTA.
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