Dr. Smith's ECG Blog

AUGUST 6, 2024

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.

Chest Pain 104

Chest Pain Ischemia Pericarditis Tachycardia 104

Dr. Smith's ECG Blog

DECEMBER 11, 2023

Recall from this post referencing this study that "reciprocal STD in aVL is highly sensitive for inferior OMI (far better than STEMI criteria) and excludes pericarditis, but is not specific for OMI." Her contrast enhanced echocardiogram is shown below in the parasternal short axis view. The patient suffered a large infarct. Worrall, C.,

Myocardial Infarction 123

Myocardial Infarction Chest Pain STEMI Blood Pressure 123

Dr. Smith's ECG Blog

JANUARY 15, 2024

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 November 10, 2020 post — for PTA. The case continues.

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Chest Pain Blog Arrhythmia Critical Care 64

Dr. Smith's ECG Blog

NOVEMBER 1, 2022

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

Chest Pain 52

Chest Pain Coronary Artery Bypass Graft Pericarditis Blog 52

Dr. Anish Koka

FEBRUARY 20, 2023

It is relevant to note here that as a physician active clinically in both the inpatient and outpatient arenas, I am an eyewitness to the severe toll COVID19 took on my patients in the Spring or 2020. He has had COVID twice, first in September of 2020, and his second time in January of 2023. The pain resolved a few weeks later.

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COVID-19 Pericarditis Chest Pain Public Health 52

Dr. Smith's ECG Blog

FEBRUARY 16, 2025

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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STEMI Pericarditis Chest Pain Echocardiogram 72