2020 Pericarditis Stents 
Dr. Smith's ECG Blog
AUGUST 6, 2024
These latter findings are typical of pericarditis, but pericarditis never has reciprocal ST depression. This led to immediate cath lab activation — which revealed total occlusion of a large 1st diagonal branch that was stented. == Below is the ECG of Patient #3 — recorded from a 35-year old man with sudden, new-onset CP.
Dr. Smith's ECG Blog
NOVEMBER 29, 2023
Of course the patient was saddled with the erroneous "pericarditis" diagnosis after CTs ruled also ruled out PE and dissection. The patient was found to have total "mid" LAD occlusion which was stented: Pre-PCI. Serial ECGs remained unchanged. Echo showed normal EF and no wall motion abnormalities, and no pericardial effusion.
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." Here is the angiogram after stent placement. Academic Emergency Medicine 27(S1): S220; May 2020. link] Bischof, J. Worrall, C.,
Dr. Smith's ECG Blog
NOVEMBER 1, 2022
The 50-something patient with history of coronary stenting and slightly reduced LV ejection fraction. In the setting of prior stenting and reduced left ventricular ejection fraction, would pursue a heart team revascularization approach Syntax score 28.5, Pericarditis would be even more unlikely in someone without chest pain.
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. The true AV groove LCx was "jailed" by the stent and appears occluded in the post PCI image. The OM is a much larger vessel.
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