Remove 2020 Remove Pericarditis Remove Ultrasound
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Viral symptoms, then acute chest pain and this ECG. What do you do?

Dr. Smith's ECG Blog

It could also be due to pericarditis or myocarditis, but I always say that "you diagnose pericarditis at your peril." The clinical presentation is very suggestive of myo-pericarditis. But one should always remember that acute MI is a far more common pathology than myo- or pericarditis. Pericarditis?

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A 20-something with intermittent then acute chest pain

Dr. Smith's ECG Blog

No pericardial effusion on ultrasound." First, many on Twitter said "Pericarditis". This is NOT pericarditis, which virtually NEVER has ST depression any where except aVR. ECG diffuse ST elevation, but lacking pericarditis features, and very concerning for acute injury." What do you think?

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A woman in her 20s with syncope

Dr. Smith's ECG Blog

A bedside cardiac ultrasound was performed with a parasternal long axis view demonstrated below: There is a large pericardial effusion with collapse of the right ventricle during systole. The second most common cause of medical cardiac tamponade is acute idiopathic pericarditis. This patient is only pseudo-stable. Her pulse is 125.

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Noisy, low amplitude ECG in a patient with chest pain

Dr. Smith's ECG Blog

A bedside ultrasound should be done to assess volume and other etiologies of tachycardia, but if no cause of type 2 MI is found, the cath lab should be activated NOW. The "flu-like" illness suggests myo- or pericarditis, but that would be a diagnosis of exclusion. The November 10, 2020 post — for PTA.

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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

Pericarditis? Beware a negative Bedside ultrasound. 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 ). 24 yo woman with chest pain: Is this STEMI?