Dr. Smith's ECG Blog

DECEMBER 20, 2013

Here is his initial ED ECG: The R-wave in V4 extends to 33 mm, the computerized QTc is 372 ms The only available previous ECG is from one year ago, during the admission when he was diagnosed with pericarditis: 1 year ago ECG, with clinician and computer interpretatioin of pericarditis Normal 0 false false false EN-US X-NONE X-NONE What do you think?

Pericarditis 52

Pericarditis Chest Pain Pulmonary STEMI 52

Dr. Smith's ECG Blog

JANUARY 12, 2023

CT pulmonary angiogram was negative for pulmonary embolism. If the patient continues to have reperfusion, then we would expect progressive terminal T wave inversion then full T wave inversion over time in the future ECGs. Second troponin T resulted at 1,318 ng/L. Chest x-ray was read as normal. Heparin was started. Reocclusion!

Chest Pain 52

Chest Pain STEMI Blog Stenosis 52

All About Cardiovascular System and Disorders

OCTOBER 26, 2023

They include myocardial ischemia, acute pericarditis, pulmonary embolism, external compression due to mass over the right ventricular outflow tract region, and metabolic disorders like hyper or hypokalemia and hypercalcemia. 2020 Sep;31(9):2474-2483. J Cardiovasc Electrophysiol. Arch Cardiovasc Dis. 2017 Mar;110(3):188-195.

Sudden Cardiac Death 52

Sudden Cardiac Death Atrial Fibrillation Electrophysiology Arrhythmia 52

Dr. Smith's ECG Blog

JANUARY 15, 2024

The "flu-like" illness suggests myo- or pericarditis, but that would be a diagnosis of exclusion. Then, part of the thrombus embolized into the LCx causing an inferoposterolateral OMI. (As The November 10, 2020 post — for PTA. The October 17, 2020 post — for a 70-year old woman with " Artifactual VT ". The case continues.

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Chest Pain Blog Arrhythmia Critical Care 64

Dr. Smith's ECG Blog

JANUARY 9, 2023

CT angiogram chest: no aortic dissection or pulmonary embolism. Pericarditis? There is a literature on this subject ( GGF van der Schoot et al: Neth Heart J 28(6):301-308, 2020 — and — Egred et al — Postgrad Med 81(962): 741-745, 2005 — to name just 2 reports ). No further troponins were measured.

Chest Pain 52

Chest Pain Aneurysm STEMI Thrombosis 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. Even if it is not atherosclerotic, young people can have embolic OMIs. The emergency physician consulted cardiology.

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STEMI Pericarditis Chest Pain Echocardiogram 72