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ECG Blog #365 — A 30yo with Pericarditis.

Ken Grauer, MD

The patient was discharged with a diagnosis of acute pericarditis — and treated with a full course of colchicine and ibuprofen. The ultimate discharge diagnosis was acute pericarditis. ( See ECG Blog #215 — for more on the Cabrera format. = From the information provided — I would not make the diagnosis of acute pericarditis.

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What does this ECG show?

Dr. Smith's ECG Blog

Overall, this looks like one of the rare ECGs that is actually specific for pericarditis in my opinion. QOH versions 1 and 2 both say Not OMI, with high confidence, without any clinical context, despite the abnormal STE meeting STEMI criteria. Pericarditis maybe." There was no prior ECG for comparison.

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ECG Cases 27 Pericarditis – Diagnosis of Exclusion

ECG Cases

Jesse McLaren guides us through 9 cases and explains how pericarditis is a diagnosis of exclusion through 3 simple steps: 1. Exclude complications of pericarditis, eg myocarditis, large pericardial effusion 3. Exclude normal variant ST elevation presenting with benign chest pain on this month's ECG Cases blog.

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

ECG Cases

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.

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"Pericarditis" strikes again

Dr. Smith's ECG Blog

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."

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What would you do with acute chest pain and this ECG? You might see what the Queen thinks.

Dr. Smith's ECG Blog

His EKG with worse pain now shows enough ST elevation to meet STEMI criteria. The undergraduate continues: This new EKG pattern is more suggestive of acute pericarditis. Usually with pericarditis, some degree of PR segment depression is expected. This is typical of pericarditis. This EKG seems to lack it.

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Why the sudden shock after a few days of malaise?

Dr. Smith's ECG Blog

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.