Aortic, Chest Pain and Pericarditis - Cardiovascular Update

Acute chest pain and ST Elevation. CT done to look for aortic dissection.

Dr. Smith's ECG Blog

MARCH 9, 2024

Written by Willy Frick A 67 year old man with a history of hypertension presented with three days of chest pain radiating to his back. This ECG together with these symptoms is certainly concerning for OMI, but the ECG is not fully diagnostic, and another consideration could be acute pericarditis. What do you think?

Chest Pain

Chest Pain Pericarditis Aortic Echocardiogram

What does this ECG show?

Dr. Smith's ECG Blog

AUGUST 4, 2024

Overall, this looks like one of the rare ECGs that is actually specific for pericarditis in my opinion. Pericarditis maybe." Context: a man in his 40s presented to the emergency department with 1 day of sudden onset chest pain. Meyers' words — "is one of the rare ECGs that is actually specific for pericarditis".

Pericarditis

Pericarditis Chest Pain Blog Aortic

"Pericarditis" strikes again

Dr. Smith's ECG Blog

DECEMBER 13, 2019

Written by Pendell Meyers A man in his late 40s with several ACS risk factors presented with a chief complaint of chest pain. Several hours prior to presentation, while driving his truck, he started experiencing new central chest pain, without radiation, aggravating/alleviating factors, or other associated symptoms.

Pericarditis

Pericarditis Chest Pain Aortic Blog

Webinars

Bridging Innovation & Patient Care: The Growing Role of AI

MORE WEBINARS

Differentiating Between Cardiac and Non-Cardiac Chest Pain

All About Cardiovascular System and Disorders

APRIL 10, 2024

It is not always possible to be certain about the origin of chest pain just by its characteristics as the variation between individuals is quite a bit. A medical opinion should be sought in case of any significant chest pain so that important ailment is not missed. A pain lasting more than 30 minutes is usual.

Chest Pain

Chest Pain Angina Pericarditis Exercise

Vomiting, Diarrhea, and "Bubbles in my Chest"

Dr. Smith's ECG Blog

FEBRUARY 12, 2024

Post op chest pain Typical of post-op pericarditis (postpericardiotomy syndrome) There is ST Elevation in II ＞ III, and STE in V3-5, but with flat T-wave. The ST elevation is far more prominent than the T-wave and this is what I see as the defining feature differentiating OMI from pericarditis.

Pericarditis

Pericarditis Chest Pain Bradycardia Aortic

Why the sudden shock after a few days of malaise?

Dr. Smith's ECG Blog

SEPTEMBER 5, 2024

This is a value typical for a large subacute MI, n ormal value 48 hours after myocardial infarction is associated with Post-Infarction Regional Pericarditis ( PIRP ). As already mentioned, this patient could have post-infarction regional pericarditis from a large completed MI. Sinus tachycardia has many potential causes. Hammill SC.

Cardiogenic Shock

Cardiogenic Shock Chest Pain Pericarditis Myocardial Infarction

ECG Cases 42 – Approach to ECG Interpretation in Patients with Chest Pain: OMI, False Positive & Negative STEMI & Other Causes

ECG Cases

MAY 10, 2023

In this ECG Cases blog we look at 10 cases of patients with chest pain, including false positive STEMI, false negative STEMI, and other causes to help hone your ECG interpretation skills in time-sensitive cases where those very ECG skills might save a life.

Chest Pain

Chest Pain STEMI Blog Embolism

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

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?

Chest Pain

Chest Pain Aneurysm STEMI Thrombosis

A woman in her 70s with chest pain

Dr. Smith's ECG Blog

DECEMBER 18, 2022

Submitted and written by Quinton Nannet, MD, peer reviewed by Meyers, Grauer, Smith A woman in her 70s recently diagnosed with COVID was brought in by EMS after she experienced acute onset sharp midsternal chest pain without radiation or dyspnea. She was taken immediately for a CT angiogram of the chest, abdomen and pelvis.

Chest Pain

Chest Pain Ischemia Aortic Aortic valve

An elderly male with shortness of breath

Dr. Smith's ECG Blog

SEPTEMBER 7, 2024

He reports significant chest pain at the base of his scapula on the right side along with new shortness of breath. They also wanted an aortic CT which was negative. Wellen's waves indicate that, when the patient was having chest pain, there was occlusion. What do you think the prehospital ECG showed (with pain)?

Chest Pain

Chest Pain Myocardial Infarction STEMI Pericarditis

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

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).

STEMI

STEMI Pericarditis Myocardial Infarction Cardiogenic Shock

A teenager involved in a motor vehicle collision with abnormal ECG

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. Massive Transfusion for Motorcycle Collision with Hemorrhage, Troponin Elevated. ST depression. Myocardial Contusion?

Tachycardia

Tachycardia Dysrhythmia Atrial Fibrillation Bradycardia

Cardiologist declines taking patient to the cath lab. Patient dies.

Dr. Smith's ECG Blog

OCTOBER 11, 2020

Apparently he denied chest pain. As always, takotsubo cardiomyopathy and focal pericarditis can mimic OMI, but takotsubo almost never mimics posterior MI, and both are diagnoses of exclusion after a negative cath. JAMA 2000) showed that 1/3 of patients with STEMI, and 1/3 of patients with NSTEMI, present without chest pain.

Chest Pain

Chest Pain STEMI Blog Tachycardia

Inferior Subtle ST elevation: straight ST segment, but also no reciprocal ST depression in aVL: which is more important?

Dr. Smith's ECG Blog

JUNE 28, 2019

60-something with h/o MI and stents presented with chest pain radiating to the back and nausea/vomiting. Pericarditis? There was concern for aortic dissection, so a CT was done and was negative. A straight ST segment virtually never happens in inferior ST elevation that is NOT due to OMI (normal variant, pericarditis) 4.

Chest Pain

Chest Pain Pericarditis Stents Stent

Patient in Single Vehicle Crash: What is this ST Elevation, with Peak Troponin of 6500 ng/L?

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. ST depression. Myocardial Contusion?

Arrhythmia

Arrhythmia Blog Chest Pain Cardiac Arrest

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

Dr. Smith's ECG Blog

FEBRUARY 26, 2025

Scenario 1 : The patient presents with 24 hours of substernal chest pain. 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.

Chest Pain

Chest Pain Pericarditis Myocardial Infarction Dementia

Acute chest pain and ST Elevation. CT done to look for aortic dissection.

What does this ECG show?

"Pericarditis" strikes again

Webinars

Differentiating Between Cardiac and Non-Cardiac Chest Pain

Vomiting, Diarrhea, and "Bubbles in my Chest"

Why the sudden shock after a few days of malaise?

ECG Cases 42 – Approach to ECG Interpretation in Patients with Chest Pain: OMI, False Positive & Negative STEMI & Other Causes

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

A woman in her 70s with chest pain

An elderly male with shortness of breath

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

A teenager involved in a motor vehicle collision with abnormal ECG

Cardiologist declines taking patient to the cath lab. Patient dies.

Inferior Subtle ST elevation: straight ST segment, but also no reciprocal ST depression in aVL: which is more important?

Patient in Single Vehicle Crash: What is this ST Elevation, with Peak Troponin of 6500 ng/L?

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

Stay Connected