Remove Aneurysm Remove Outcomes Remove Pericarditis
article thumbnail

Watch what happens when "pericarditis" and morphine cloud your judgment

Dr. Smith's ECG Blog

06:44 - T-waves in V2 are smaller now - Overall resolution of prior findings (which qualifies as a dynamic change) The initial note by the cardiologist states that the presentation is more consistent with pericarditis. Remember, pericarditis is the thing you say and write down when youre actively trying to miss an OMI.

article thumbnail

Subacute AnteroSeptal STEMI, With Persistent ST elevation and Upright T-waves

Dr. Smith's ECG Blog

such Q-waves are associated with larger MI and worse outcomes (2. When there is MI extending all the way to the epicardium (transmural), that infarcted epicardium is often inflamed (postinfarction regional pericarditis, or PIRP). What complication is the patient with post-infarction regional pericarditis at risk for?

STEMI 52
article thumbnail

Initial Reperfusion T-waves, Followed by Pseudonormalization. Diagnosis?

Dr. Smith's ECG Blog

Post-infarction Regional Pericarditis (PIRP) PIRP happens when MI is transmural, all the way from subendocardium to subepicardium, thus leading to inflammation of the subepicardium (next to the pericardium). MYOCARDIAL RUPTURE AND POSTINFARCTION REGIONAL PERICARDITIS KEY POINTS · Myocardial rupture occurs in 1 to 1.5% Re-occlusion 2.

article thumbnail

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

Dr. Smith's ECG Blog

Repeat CT angio chest (not CT coronary, unclear what protocol) showed possible LAD aneurysm and thrombus. Finally, coronary angiography was performed (at least 5 days after presentation) which confirmed LAD aneurysm with large thrombus burden, TIMI 0 flow, thrombectomy performed. Pericarditis? No further cath details available.

article thumbnail

Chest pain followed by 6 days of increasing dyspnea -- what happened?

Dr. Smith's ECG Blog

When there are QS-waves, one should always think about LV aneurysm, but ST to QRS ratio and T-wave to QRS ratio are far too large and not compatible with left ventricular aneurysm. These findings together are more commonly seen with pericarditis. There is some R wave in the lateral precordial leads.