Remove 2020 Remove Pericarditis Remove Pulmonary
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31 Year Old Male with RUQ Pain and a History of Pericarditis. Submitted by a Med Student, with Great Commentary on Bias!

Dr. Smith's ECG Blog

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?

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Biosense Webster Submits Application to U.S. FDA Seeking Approval of the VARIPULSE Platform for the Treatment of Paroxysmal Atrial Fibrillation

DAIC

The VARIPULSE Platform is designed to enable pulmonary vein isolation with the versatility of a catheter loop, a simple generator user interface, and a mapping system that provides an intuitive, reproducible workflow with real-time visualization, contact indicator, and PF tagging mechanisms. Epub 2020 Jan 19. 2020 June;127(1):4-20.

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Does this T wave pattern mean anything?

Dr. Smith's ECG Blog

Conduction and refractoriness alternans may be seen with WPW-related as well as AV Nodal-dependent reentr y tachycardias — atrial fibrillation — acute pulmonary embolus — myocardial contusion — and severe LV dysfunction. Therefore — identification of QRS alternans during a regular SVT does not prove the existence of an accessory pathway.

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Brugada Syndrome: Diagnosis and Risk Stratification

All About Cardiovascular System and Disorders

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.

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A woman in her 20s with syncope

Dr. Smith's ECG Blog

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?

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A teenager with chest pain, a troponin below the limit of detection, and "benign early repolarization"

Dr. Smith's ECG Blog

CT angiogram chest: no aortic dissection or pulmonary embolism. Serial chest xrays: progressive bilateral pulmonary edema. 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 ).

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Quiz post: do either or both of these patients have high lateral OMI / South African flag sign?

Dr. Smith's ECG Blog

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!