Aneurysm Chest Pain Pericarditis 
Dr. Smith's ECG Blog
JULY 3, 2018
Submitted and written by Alex Bracey with edits by Pendell Meyers and Steve Smith Case A 50ish year old man with a history of CAD w/ prior LAD MI s/p LAD stenting presented to the ED with chest pain similar to his prior MI, but worse. The pain initially started the day prior to presentation. The ST elevation from today is ~0.2
Dr. Smith's ECG Blog
JANUARY 9, 2023
No prior exertional complaints of chest pain, dizziness, lightheadedness, or undue shortness of breath. He denied headache or neck pain associated with exertion. I sent this ECG to Dr. Smith, with the only information that it is a 17 year old with chest pain. 24 yo woman with chest pain: Is this STEMI?
Dr. Smith's ECG Blog
JULY 19, 2019
Written by Pendell Meyers, with edits by Steve Smith A man in his early 40s with history of MI s/p PCI presented with bilateral anterior chest pain described as burning and belching with no radiation since last night starting around 11pm (roughly 11 hours ago). The patient was still with ongoing chest pain at the time ECG #1 was done.
Dr. Smith's ECG Blog
JUNE 18, 2011
3 hours prior to calling 911 he developed typical chest pain. The old ECG has a Q-wave with persistent ST elevation in lead III, and some reciprocal ST depression (typical for aneurysm morphology). This rules out pericarditis, which essentially never has reciprocal ST depression. This is not pericarditis because: a.
Dr. Smith's ECG Blog
JULY 18, 2014
A man in his 60's presented after 4 days of chest pain, with some increase of pain on the day of presentation. Exact pain history was difficult to ascertain. When there is MI extending all the way to the epicardium (transmural), that infarcted epicardium is often inflamed (postinfarction regional pericarditis, or PIRP).
Dr. Smith's ECG Blog
MARCH 11, 2019
You do NOT see this in normal variant STE, nor in pericarditis. The only time you see this without ischemia is when there is an abnormal QRS, such as LVH, LBBB, LV aneurysm (old MI with persistent STE) or WPW." At some point he returned with chest pain, and all these findings were put into place.
Dr. Smith's ECG Blog
FEBRUARY 29, 2016
He denied fevers and chills, abdominal pain, chest pain, or SOB. This may be permanent and may be associated with echocardiographic dyskinesis (aneurysm). LV aneurysm is common in completed, full thickness (transmural) MI, which is what we have here. Patient stated his dry weight is around 85 kg.
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