Remove Cardiac Arrest Remove Cardiomyopathy Remove Pericarditis
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Does this T wave pattern mean anything?

Dr. Smith's ECG Blog

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 cardiac arrest with return of spontaneous circulation. The described rhythm was an irregular, wide complex rhythm.

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A woman in her 20s with syncope

Dr. Smith's ECG Blog

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.

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

Dr. Smith's ECG Blog

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 cardiac arrest (whether it was VF/VT or PEA is not available) and expired.

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A woman in her 70s with chest pain

Dr. Smith's ECG Blog

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?

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Unconscious + STEMI criteria: activate the cath lab?

Dr. Smith's ECG Blog

The relationship between J wave and ventricular tachycardia during Takotsubo cardiomyopathy. 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 cardiac arrest ).

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