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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. 7 Secondary prevention following myocardialinfarction: a clinical update. 2019 Dec 26;381(26):2497-2505.
These latter findings are typical of pericarditis, but pericarditis never has reciprocal ST depression. The ECG is diagnostic of occlusion myocardialinfarction (OMI). Usually with pericarditis and myocarditis — hyperacute T waves (HATW) are not present. S mith : there is STE in lead III and reciprocal STD in aVL.
First, many on Twitter said "Pericarditis". This is NOT pericarditis, which virtually NEVER has ST depression any where except aVR. See our publication: ST depression in lead aVL differentiates inferior ST-elevation myocardialinfarction from pericarditis There is STE in inferior leads, high lateral leads, and V4-V6.
This is a bad ST vector orientation, because it causes widespread STE and one of the most important mistakes that needs to be avoided here is thinking of the diagnosis of pericarditis. Such an out-of-proportion STE is virtually never seen in pericarditis. Considerations on the naming of myocardialinfarctions. 2019.09465.
I do not think this is acute occlusion myocardialinfarction (OMI). 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. Get an emergent contrast echocardiogram.
You do NOT see this in normal variant STE, nor in pericarditis. Cardiac Troponin Changes to Distinguish Type 1 and Type 2 MyocardialInfarction and 180-Day Mortality Risk. Here is the computer interpretation: (Veritas algorithm) This is what I said: "This is diagnostic of an acute inferior MI. Murakami M.
The initial computer and final cardiology interpretation was a differential: “ST elevation, consider early repolarization, pericarditis, or injury.” Hyperacute T waves can be a useful sign of occlusion myocardialinfarction if appropriately defined. But STEMI criteria ignore all this and look at ST segments in isolation.
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