Aortic 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

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. Mistaking OMI for pericarditis is a much more harmful error than the converse. The rate is tachycardic, which is uncommon in OMI and common in pericarditis.

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." Two weeks ago he had a significant MVC with many severe injuries, including aortic injury s/p endovascular repair. 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

mm has been described in normal subjects) Overall impression: In my opinion and experience, this ECG most likely represents a normal baseline ECG, but with a small chance of pericarditis instead. I texted this to Dr. Smith without any information, and this was his reply: "This could be pericarditis but probably is normal variant."

Pericarditis

Pericarditis Chest Pain Aortic Blog

Webinars

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Long-Term Outcomes in Pericarditis, Polygenic Risk Score and Predicting CVD, Aortic Disease in Children with FBN1-Related Marfan Syndrome

American College of Cardiology

SEPTEMBER 18, 2024

In this weekâ€™s View, Dr. Eagle looks at predicting long-term outcomes in patients with recurrent pericarditis.

Pericarditis

Pericarditis Outcomes Aortic Article

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

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

Dr. Smith's ECG Blog

JULY 18, 2014

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? 3) Oliva et al. (4) Lessons : 1. One should be on the alert for myocardial rupture.

STEMI

STEMI Pericarditis Myocardial Infarction Cardiogenic Shock

Differentiating Between Cardiac and Non-Cardiac Chest Pain

All About Cardiovascular System and Disorders

APRIL 10, 2024

Another type of pain originating from the heart is due to an inflammation of its covering known as pericarditis. Pain of pericarditis can increase on swallowing and mimic pain from the food pipe. Pain of aortic dissection is tearing type and is most severe in the beginning. Pain may be relieved on leaning forwards.

Chest Pain

Chest Pain Angina Pericarditis Exercise

A woman in her 70s with chest pain

Dr. Smith's ECG Blog

DECEMBER 18, 2022

A dissection flap is noted in the intrabdominal aorta, and the aortic outflow tract is also noted to appear wider than normal. The CT angio showed a type A aortic dissection extending from the aortic root proximally to the carotid and left subclavian artery and distally to the common femoral arteries.

Chest Pain

Chest Pain Ischemia Aortic Aortic valve

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. : A Child with Blunt Trauma -- See how the ECG can be definite for myocardial contusion, but subtle, and what happens if you miss it.

Tachycardia

Tachycardia Dysrhythmia Atrial Fibrillation Bradycardia

An elderly male with shortness of breath

Dr. Smith's ECG Blog

SEPTEMBER 7, 2024

Then the patient's pain then resolved spontaneously after 2 sublingual nitroglycerine and another ECG was recorded ECG 2 at 16 minutes ST ELEVATION CONSISTENT WITH INJURY, PERICARDITIS, OR EARLY REPOLARIZATION Overread same Smith : The T-waves are now MUCH smaller. They also wanted an aortic CT which was negative.

Chest Pain

Chest Pain Myocardial Infarction STEMI Pericarditis

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

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. 60-something with h/o MI and stents presented with chest pain radiating to the back and nausea/vomiting.

Chest Pain

Chest Pain Pericarditis Stent Stents

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

Dr. Smith's ECG Blog

OCTOBER 11, 2020

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. Chest pain and Concordant ST Depression in a patient with aortic valve and previously normal angiogram Right Bundle Branch Block and ST Depression in V1-V3.

Chest Pain

Chest Pain STEMI Blog Tachycardia

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

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

CT angiogram chest: no aortic dissection or pulmonary embolism. Pericarditis? He spent several days in the PICU, undergoing workup including: Serial troponins: rising from 5,700 ng/L (unknown if I or T) to greater than 25,000 ng/L (greater than the lab's upper limit of reporting). No further troponins were measured.

Chest Pain

Chest Pain Aneurysm STEMI Thrombosis

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

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.

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

Long-Term Outcomes in Pericarditis, Polygenic Risk Score and Predicting CVD, Aortic Disease in Children with FBN1-Related Marfan Syndrome

Vomiting, Diarrhea, and "Bubbles in my Chest"

Why the sudden shock after a few days of malaise?

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

Differentiating Between Cardiac and Non-Cardiac Chest Pain

A woman in her 70s with chest pain

A teenager involved in a motor vehicle collision with abnormal ECG

An elderly male with shortness of breath

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

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

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

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"

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

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