Dr. Smith's ECG Blog

JUNE 17, 2024

Echocardiogram showed severe RV dilation with McConnell’s sign and an elevated RVSP. Dyspnea, Chest pain, Tachypneic, Ill appearing: Bedside Cardiac Echo gives the Diagnosis 31 Year Old Male with RUQ Pain and a History of Pericarditis. The patient was upgraded to the ICU for closer monitoring. What is the Diagnosis?

Chest Pain 140

Chest Pain Embolism Pulmonary Tachycardia 140

Dr. Smith's ECG Blog

AUGUST 6, 2024

These latter findings are typical of pericarditis, but pericarditis never has reciprocal ST depression. Elevated troponins prompted an echocardiogram — which revealed an apical wall motion abnormality (WMA). Usually with pericarditis and myocarditis — hyperacute T waves (HATW) are not present.

Chest Pain 105

Chest Pain Ischemia Pericarditis Tachycardia 105

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? No resolution of ST elevation. The T-waves are persistently positive. Lessons : 1.

STEMI 52

STEMI Pericarditis Myocardial Infarction Cardiogenic Shock 52

Dr. Smith's ECG Blog

JULY 7, 2013

When there is MI extending all the way to the epicardium (transmural), that infarcted epicardium is often inflamed (postinfarction regional pericarditis, or PIRP). 3) strongly associated myocardial rupture with postinfarction regional pericarditis (PIRP) , and associated PIRP with persistent upright T-waves. 3) Oliva et al. (3)

STEMI 52

STEMI Myocardial Infarction Pericarditis Ultrasound 52

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. The S-wave is reconstituted. The inferior findings are much less pronounced.

Chest Pain 117

Chest Pain Myocardial Infarction STEMI Pericarditis 117

Dr. Smith's ECG Blog

JANUARY 15, 2024

ECG 2 Especially in the context of the first ECG, readers of this blog will readily appreciate the ST elevations and hyperacute T waves in II, III, aVF, V6, and to a lesser extent V5. The "flu-like" illness suggests myo- or pericarditis, but that would be a diagnosis of exclusion. [link] I also texted the ECG to Dr. Smith.

Chest Pain 65

Chest Pain Blog Arrhythmia Critical Care 65

Dr. Smith's ECG Blog

SEPTEMBER 9, 2024

The patient was thought to have low likelihood of ACS, and cardiology recommended repeat troponin, urine drug testing, and echocardiogram. Bedside echocardiogram showed hypokinesis of the mid to distal anterior wall and apex. Initial hscTnI was 10 ng/L (ref. <14). There was no recommendation for repeat ECG.

Plaque 67

Plaque Stents Stent Chest Pain 67

Dr. Smith's ECG Blog

NOVEMBER 1, 2022

Assessment:" " Nonspecific ST elevation from V1-V4 , question of early repolarization versus pericarditis , question of acute current of injury and ? Pericarditis would be even more unlikely in someone without chest pain. Precordial Swirl in ECG #1: As discussed in the October 15, 2022 post in Dr. Smith's ECG Blog — Drs.

Chest Pain 52

Chest Pain Coronary Artery Bypass Graft Pericarditis Blog 52

Dr. Smith's ECG Blog

NOVEMBER 25, 2022

An echocardiogram was done. 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. Is there also Brugada? Here is the result: The estimated left ventricular ejection fraction is 50 %.

Arrhythmia 52

Arrhythmia Blog Chest Pain Cardiac Arrest 52

Dr. Smith's ECG Blog

JULY 21, 2019

Get an emergent contrast echocardiogram. There is also mild pericardial enhancement consistent with pericarditis. QTc's were 330 ms and 373 ms This is what I texted back: These look like they are a very pronounced case of Benign T-wave Inversion. I do not think this is acute occlusion myocardial infarction (OMI). huge R-wave in V4 3.

Chest Pain 52

Chest Pain Myocardial Infarction Pericarditis Angina 52

Dr. Smith's ECG Blog

DECEMBER 22, 2010

Myocardial rupture is usually preceded by postinfarction regional pericarditis (PIRP). The "rupture" is not an explosion, rather a small tract through the myocardium which leaks blood into the pericardium, and kills by tamponade.

Cardiac Arrest 40

Cardiac Arrest Tachycardia STEMI Chest Pain 40

Dr. Smith's ECG Blog

FEBRUARY 16, 2025

Despite apparently hearing the above history together with two diagnostic ECGs and a troponin compatible with OMI, the cardiologist thought the ECG represented pericarditis and recommended echocardiogram. Echocardiogram was finally performed five hours after the first diagnostic ECG. Here is the wall motion diagram.

STEMI 73

STEMI Pericarditis Chest Pain Echocardiogram 73