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mm has been described in normal subjects) Overall impression: In my opinion and experience, this ECG most likely represents a normal baseline ECG, but with a small chance of pericarditis instead. I texted this to Dr. Smith without any information, and this was his reply: "This could be pericarditis but probably is normal variant."
These latter findings are typical of pericarditis, but pericarditis never has reciprocal ST depression. Elevated troponins prompted an echocardiogram — which revealed an apical wall motion abnormality (WMA). Usually with pericarditis and myocarditis — hyperacute T waves (HATW) are not present.
Get an emergent contrast echocardiogram. There is also mild pericardial enhancement consistent with pericarditis. QTc's were 330 ms and 373 ms This is what I texted back: These look like they are a very pronounced case of Benign T-wave Inversion. I do not think this is acute occlusion myocardial infarction (OMI). huge R-wave in V4 3.
Assessment:" " Nonspecific ST elevation from V1-V4 , question of early repolarization versus pericarditis , question of acute current of injury and ? Pericarditis would be even more unlikely in someone without chest pain. Initial troponin came back negative." Sodium channel blockade effect from unidentified drug?" "In
An echocardiogram was done. ECG of pneumopericardium and probable myocardial contusion shows typical pericarditis Male in 30's, 2 days after Motor Vehicle Collsion, complains of Chest Pain and Dyspnea Head On Motor Vehicle Collision. Is there also Brugada? Here is the result: The estimated left ventricular ejection fraction is 50 %.
The "flu-like" illness suggests myo- or pericarditis, but that would be a diagnosis of exclusion. While awaiting transfer to the cath lab, STAT echocardiogram was performed and showed LVEF 30-35%, as well as anterior, inferior, and apical hypokinesis, and apical thrombus. The September 22, 2019 post — intermittent ST-T wave artifact.
Despite apparently hearing the above history together with two diagnostic ECGs and a troponin compatible with OMI, the cardiologist thought the ECG represented pericarditis and recommended echocardiogram. Echocardiogram was finally performed five hours after the first diagnostic ECG. Here is the wall motion diagram.
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