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He had multiple cardiacarrests with ROSC regained each time. Dyspnea, Chest pain, Tachypneic, Ill appearing: Bedside Cardiac Echo gives the Diagnosis 31 Year Old Male with RUQ Pain and a History of Pericarditis. Cardiac Ultrasound may be a surprisingly easy way to help make the diagnosis Answer: pulmonary embolism.
Edited by Bracey, Meyers, Grauer, and Smith A 50-something-year-old female with a history of an unknown personality disorder and alcohol use disorder arrived via EMS following cardiacarrest with return of spontaneous circulation. The described rhythm was an irregular, wide complex rhythm. What is ELECTRICAL ALTERNANS?
T-wave to ST ratio is greater than 4 in lead V6, making pericarditis unlikely (also there were no symptoms of pericarditis). Sudden cardiacarrest associated with early repolarization. There is ST elevation diffusely: 2 mm in V2, 3.5 mm in V3, 2.5 mm in V4, 1.5 mm in V5, and 1 mm in V6, 1.5 The computerized QTc is 386 ms.
Smith: This bizarre ECG looks like a post cardiacarrest ECG with probable acidosis or hyperkalemia in addition to OMI. Bottom Line: Tests other than cardiac cath may be all that are needed to establish the diagnosis — but, I'd want to see a patient with this ECG as soon as would be possible. What was the pH and K?
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. About two hours after admission, he suffered a cardiacarrest (whether it was VF/VT or PEA is not available) and expired. Were they right?
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. What are the ECG Findings of Cardiac Contusion? ST depression. Myocardial Contusion?
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. What is ELECTRICAL ALTERNANS?
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?
Myocardial rupture is usually preceded by postinfarction regional pericarditis (PIRP). Patients who present with chest pain or cardiacarrest and have an ECG diagnostic of STEMI could have myocardial rupture. In a report of 6 cases at our institution (Hennepin County Medical Center), 2 survived with cardiac surgery.
Differential of peri-infarct pericardial fluid The differential includes 1) pericarditis with effusion or 2) hemopericardium. Differential of peri-infarct pericardial fluid The differential includes 1) pericarditis with effusion or 2) hemopericardium. Dressler's syndrome appears to be quite rare, according to Shahar and Lichstein.
Prominent J waves and ventricular fibrillation caused by myocarditis and pericarditis after BNT162b2 mRNA COVID-19 vaccination. The final letter in the SLOWED mnemonic is " D " for "Dead" ( resulting from VT/VF or asystolic cardiacarrest ). This is the 2nd ECG from the February 8, 2022 post in Dr. Smith's ECG Blog ).
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