Blog Pericarditis Plaque 
Dr. Smith's ECG Blog
SEPTEMBER 9, 2024
You can easily imagine this patient getting one of several diagnoses -- vasospasm, MINOCA , pericarditis, or maybe even no diagnosis at all beyond "non-obstructive coronary artery disease." Smith comment : a very high proportion of MINOCA are ruptured plaque with lysed thrombus. That plaque is at risk of thrombosing again.
Dr. Smith's ECG Blog
DECEMBER 10, 2019
Echo does not necessarily differentiate acute MI from pericarditis: both may have wall motion abnormalities. Dr. Punjabi has a fantastic radiology blog on Spectral CT: [link] A negative CT should not be relied upon to rule out ischemia. This is why I frequently write: "You diagnose pericarditis at your peril."
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.
Dr. Smith's ECG Blog
JANUARY 9, 2023
Only after her troponin peaked at 500,000 ng/L did she get her angiogram, which showed a 100% left main occlusion due to ruptured plaque. Pericarditis? Young people can suffer acute coronary occlusion, whether by typical atherosclerotic plaque rupture, or by coronary anomalies, coronary aneurysms, dissections, spasm, etc.
Dr. Smith's ECG Blog
OCTOBER 10, 2022
As in all ischemia interpretations with OMI findings, the findings can be due to type 1 AMI (example: acute coronary plaque rupture and thrombosis) or type 2 AMI (with or without fixed CAD, with severe regional supply/demand mismatch essentially equaling zero blood flow). Submitted by a Med Student, with Great Commentary on Bias!
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