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The case reports Case 1 involves a 26 year old man who developed pericarditis after the Pfizer vaccine. Pericarditis, an inflammation of the sac the heart lives in, developed about 7 days after the Pfizer vaccine. The diagnosis was made based on classic findings of inflammation on an electrocardiogram associated with acute chest pain.
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 myocardial infarction from pericarditis There is STE in inferior leads, high lateral leads, and V4-V6.
Well, don't we see diffuse ST Elevation in Myo-pericarditis (with STD in aVR)? I have summarized the m ajor e tiologic c ategories of acute myocarditis and inflammatory cardiomyopathies. So this is STEMI, right? Which artery? There is ST Elevation in every lead except aVR (STD in aVR). Could this be myopericarditis?
The most important clinical entity associated with motion alternans is large pericardial effusion — though motion alternans has also been observed in some cases of hypertrophic cardiomyopathy. It is important to appreciate that not all pericardial effusions produce electrical alternans.
Haven't you been taught that this favors pericarditis? Weren't you taught that concave morphology favors pericarditis? As always, Takotsubo stress cardiomyopathy and focal myocarditis are rare possibilities which can only be proven after a negative cath. Smith = “You diagnose acute pericarditis at your peril”.
As always, takotsubo cardiomyopathy and focal pericarditis can mimic OMI, but takotsubo almost never mimics posterior MI, and both are diagnoses of exclusion after a negative cath. And a complication. == MY Comment by K EN G RAUER, MD ( 10/11/2020 ): == It cannot be stated any clearer than what Dr. Meyers states above.
The second most common cause of medical cardiac tamponade is acute idiopathic pericarditis. Less common etiologies include uremia, bacterial or tubercular pericarditis, chronic idiopathic pericarditis, hemorrhage, and other causes such as autoimmune diseases, radiation, myxedema, etc. What is ELECTRICAL ALTERNANS?
No family history of sudden cardiac death, cardiomyopathy, premature CAD, or other cardiac issues. Pattern consistent with Takotsubo's cardiomyopathy." Pericarditis? The wall motion abnormalities of Takotsubo cardiomyopathy and LAD OMI can be similar. No similar symptoms in the past. Coxsackie serologies negative.
The relationship between J wave and ventricular tachycardia during Takotsubo cardiomyopathy. Internat J Arrhyth 2020 Uesako H, Fukikawa H, Hashimoto S, et al. Prominent J waves and ventricular fibrillation caused by myocarditis and pericarditis after BNT162b2 mRNA COVID-19 vaccination.
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