Dr. Smith's ECG Blog

FEBRUARY 6, 2024

ECG of pneumopericardium and probable myocardial contusion shows typical pericarditis Male in 30's, 2 days after Motor Vehicle Collsion, complains of Chest Pain and Dyspnea Head On Motor Vehicle Collision. Retrieved July 2, 2022, from [link] Moyé, D. Retrieved July 2, 2022, from [link] Sybrandy, K. ST depression. Zangouri, V.,

Tachycardia 114

Tachycardia Dysrhythmia Atrial Fibrillation Bradycardia 114

Dr. Smith's ECG Blog

OCTOBER 23, 2023

2022 Jul;27(4):e12939. Epub 2022 Feb 11. I last reviewed the phenomenon of electrical alternans in My Comment at the bottom of the page in the November 28, 2022 post of Dr. Smith's ECG Blog. Prolonged ST segment and T-wave alternans with torsade de pointes secondary to hypocalcemia due to hypoparathyroidism: A case report.

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Tachycardia Cardiac Arrest ICU Blog 130

Dr. Smith's ECG Blog

AUGUST 6, 2024

These latter findings are typical of pericarditis, but pericarditis never has reciprocal ST depression. Usually with pericarditis and myocarditis — hyperacute T waves (HATW) are not present. S mith : there is STE in lead III and reciprocal STD in aVL. This is OMI until proven otherwise.

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Chest Pain Ischemia Pericarditis Tachycardia 103

Dr. Smith's ECG Blog

APRIL 25, 2023

First, many on Twitter said "Pericarditis". This is NOT pericarditis, which virtually NEVER has ST depression any where except aVR. See our publication: ST depression in lead aVL differentiates inferior ST-elevation myocardial infarction from pericarditis There is STE in inferior leads, high lateral leads, and V4-V6.

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Chest Pain Pericarditis Blog Cardiomyopathy 52

Dr. Smith's ECG Blog

NOVEMBER 13, 2022

This is a bad ST vector orientation, because it causes widespread STE and one of the most important mistakes that needs to be avoided here is thinking of the diagnosis of pericarditis. Such an out-of-proportion STE is virtually never seen in pericarditis. 2022 Mar-Apr;71:44-46. Epub 2022 Jan 31. References Aslanger EK.

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Chest Pain Myocardial Infarction Blog Pericarditis 52

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 October 15, 2022 post in Dr. Smith's ECG Blog features no less than 20 ECG examples by Drs. Serial ECGs remained unchanged. But he did well.

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STEMI Chest Pain Blog Pericarditis 124

Dr. Smith's ECG Blog

SEPTEMBER 9, 2024

You can easily imagine this patient getting one of several diagnoses -- vasospasm, MINOCA , pericarditis, or maybe even no diagnosis at all beyond "non-obstructive coronary artery disease." NOTE: For review of 20 cases of "Swirl" vs Swirl "Look-Alikes" — Check out the October 15, 2022 post in Dr. Smith's ECG Blog.

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Plaque Stent Stents Chest Pain 65

Dr. Smith's ECG Blog

NOVEMBER 25, 2022

ECG of pneumopericardium and probable myocardial contusion shows typical pericarditis Male in 30's, 2 days after Motor Vehicle Collsion, complains of Chest Pain and Dyspnea Head On Motor Vehicle Collision. I've copied KEY points from My Comment in the August 6, 2022 post in Dr. Smith's ECG Blog — regarding the answer to this question.

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Arrhythmia Blog Chest Pain Cardiac Arrest 52

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. Precordial Swirl in ECG #1: As discussed in the October 15, 2022 post in Dr. Smith's ECG Blog — Drs.

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Chest Pain Coronary Artery Bypass Graft Pericarditis Blog 52

Dr. Smith's ECG Blog

NOVEMBER 28, 2022

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. As per Drs.

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Tachycardia Pericarditis Ultrasound Blood Pressure 40

Dr. Smith's ECG Blog

JANUARY 12, 2023

Here is the South African Flag sign ( Figure by Ken Grauer — with the original 12-lead from Patient 1 attached below — See his Comment from the April 8, 2022 post in Dr. Smith's ECG Blog for more on this sign ). Patient 2 has a normal variant ECG which mimics high lateral OMI, and ruled out for MI, see case below.

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Chest Pain STEMI Blog Stenosis 52

Dr. Smith's ECG Blog

DECEMBER 18, 2022

Further Reading: [link] See these relevant cases: A man in his 50s with acute chest pain and diffuse ST depression "Pericarditis" strikes again Is it important to recognize LVH Pseudo-infarction patterns?

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Chest Pain Ischemia Aortic Aortic valve 40

Dr. Paddy Barrett

APRIL 5, 2024

Traditionally used as an anti-inflammatory for pericarditis (inflammation of the lining of the heart), it has recently been shown to result in fewer major heart events in those with a recent heart attack. JACC Volume 79, Issue 17 , 3 May 2022, Pages 1690-1700 9 Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes.

Heart Disease 119

Heart Disease Coronary Artery Disease Heart Attack Heart attacks 119

Dr. Smith's ECG Blog

OCTOBER 17, 2022

Pericarditis? If you were thinking that this is pericarditis, that would be possible in the absence of any clinical information. However, there is zero PR depression which would be VERY unusual in pericarditis. P.S.: Acute pericarditis may produce diffuse ST elevation. Presence of STD is helpful; absence is not.

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Pericarditis Chest Pain Blog Arrhythmia 52

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." St depression in lead AVL differentiates inferior st-elevation myocardial infarction from pericarditis. link] Bischof, J. Worrall, C.,

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Myocardial Infarction Chest Pain STEMI Blood Pressure 122

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. 2022 Mar;8(3):386-405. According to a recent systematic review and meta-analysis, spontaneous type 1 ECG had 2.4%

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Sudden Cardiac Death Atrial Fibrillation Electrophysiology Arrhythmia 52

Dr. Smith's ECG Blog

JANUARY 17, 2024

The initial computer and final cardiology interpretation was a differential: “ST elevation, consider early repolarization, pericarditis, or injury.” But STEMI criteria ignore all this and look at ST segments in isolation. Based on STEMI criteria and unhelpful computer interpretation, the patient was rushed to the cath lab.

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Chest Pain STEMI Myocardial Infarction Blog 117

Dr. Smith's ECG Blog

JANUARY 15, 2024

The "flu-like" illness suggests myo- or pericarditis, but that would be a diagnosis of exclusion. The October 21, 2022 post — for " artifactual VT". 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 case continues.

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Chest Pain Blog Arrhythmia Critical Care 63

Dr. Smith's ECG Blog

OCTOBER 10, 2022

Dyspnea, Chest pain, Tachypneic, Ill appearing: Bedside Cardiac Echo gives the Diagnosis 31 Year Old Male with RUQ Pain and a History of Pericarditis. NOTE: For more on the ECG diagnosis of acute RV "strain" ( and acute PE ) — Please check out My Comment at the bottom of the page in the March 28, 2022 post in Dr. Smith's ECG Blog.

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Dr. Smith's ECG Blog

MAY 23, 2022

First Troponin I was <2 and peak was 8, echo showed subtle apical lateral hypokinesis, CRP was elevated, and patient was discharged with a diagnosis of regional pericarditis. In this case, there would be evolution, but the evolution would be typical of pericarditis (if the diagnosis of pericarditis was accurate!!

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Chest Pain STEMI Pericarditis Arrhythmia 52

Dr. Smith's ECG Blog

DECEMBER 5, 2023

Though less prevalent in younger patients, occlusion MI may occur and requires the same early interventions as older patients. - - Pericarditis and myocarditis should be a diagnosis of exclusion. I've listed potential causes of acute pericarditis in My Comment at the bottom of the page in the June 11, 2022 post in Dr. Smith's ECG Blog.

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Pediatrics Pericarditis COVID-19 Congenital Heart Disease 119

Dr. Smith's ECG Blog

FEBRUARY 26, 2025

The exception is with postinfarction pericarditis , in which a completed transmural infarct results in inflammation of the subepicardial myocardium and STE in the distribution of the infarct, and which results in increased STE and large upright T-waves. These findings together are more commonly seen with pericarditis.

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Chest Pain Pericarditis Myocardial Infarction Dementia 88

Dr. Smith's ECG Blog

JANUARY 21, 2023

Prominent J waves and ventricular fibrillation caused by myocarditis and pericarditis after BNT162b2 mRNA COVID-19 vaccination. Can J Cardiol 2022 Kukla P, Jastrezebski M, Praefort W. This is the 2nd ECG from the February 8, 2022 post in Dr. Smith's ECG Blog ). Internat J Arrhyth 2020 Uesako H, Fukikawa H, Hashimoto S, et al.

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STEMI Bradycardia Arrhythmia Cardiac Arrest 52

Heart BMJ

NOVEMBER 19, 2024

The ‘post-vaccination’ cohort comprised vaccinated patients with CHD and matched controls with first-recorded SARS-CoV-2 infection between 1 March 2021 and 1 April 2022, at least 14 days after vaccination (57 550 cases, 225 160 controls). Odds of severe COVID-19 outcomes were compared using conditional logistic regression.

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