Remove 2019 Remove Pericarditis Remove Tachycardia
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"Pericarditis" strikes again

Dr. Smith's ECG Blog

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."

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A 29 year old male with chest pain, ST Elevation, and very elevated troponin T

Dr. Smith's ECG Blog

It is easy to say pericarditis in such a case. young male no risk factors and ST-elevation in several leads) As Dr. Smith has emphasized many times you diagnose pericarditis at your patient's and your own peril. With normal EF the tachycardia is not compensatory. Version 1 was not trained to detect myo- or pericarditis.

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A man in his late 30s with acute chest pain and ST elevation

Dr. Smith's ECG Blog

Sent by Dan Singer MD, written by Meyers, edits by Smith A man in his late 30s presented with acute chest pain and normal vitals except tachycardia at about 115 bpm. There is a reasonable chance of pericarditis in this case, or this could be a baseline." And this is because OMI is frequently misdiagnosed as pericarditis.

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Three prehospital ECGs in patients with chest pain

Dr. Smith's ECG Blog

These latter findings are typical of pericarditis, but pericarditis never has reciprocal ST depression. Usually with pericarditis and myocarditis — hyperacute T waves (HATW) are not present. NOTE #1: Sinus tachycardia is not usually seen in an uncomplicated acute MI. This is OMI until proven otherwise.

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A 53 yo woman with cardiogenic shock. Believe me, this is not what you think.

Dr. Smith's ECG Blog

Here was the ECG: There is sinus tachycardia. Well, don't we see diffuse ST Elevation in Myo-pericarditis (with STD in aVR)? This was sent by a reader. A previously healthy 53 yo woman was transferred to a receiving hospital in cardiogenic shock. and K was normal. This is "Shark Fin" morphology. So this is STEMI, right? Which artery?

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A young woman in her early 20s with syncope

Dr. Smith's ECG Blog

She was diagnosed with pericarditis and spent one day in the hospital without events. Much more classic findings of pericarditis. Learning Points: Pericardial effusion is a key piece of information for the diagnosis and prognosis of pericarditis. Another ECG was performed, and this time was noted to be markedly abnormal.

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Noisy, low amplitude ECG in a patient with chest pain

Dr. Smith's ECG Blog

We can see enough to make out that the rhythm is sinus tachycardia. Tachycardia is unusual for OMI, unless the patient is in cardiogenic shock (or getting close). 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.