Dr. Smith's ECG Blog

SEPTEMBER 5, 2024

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. The VSR is what is causing the cardiogenic shock!

Cardiogenic Shock 105

Cardiogenic Shock Chest Pain Pericarditis Myocardial Infarction 105

Dr. Smith's ECG Blog

FEBRUARY 16, 2020

A previously healthy 53 yo woman was transferred to a receiving hospital in cardiogenic shock. Well, don't we see diffuse ST Elevation in Myo-pericarditis (with STD in aVR)? Referring to Figure-1 — this 53-year old woman who presented in extremis with cardiogenic shock and an initial pH = 6.9, and K was normal.

Cardiogenic Shock 52

Cardiogenic Shock STEMI Pericarditis Ischemia 52

ECG Cases

MARCH 29, 2022

When should we consider myocarditis or pericarditis in patients with recent COVID-19 infection or COVID mRNA vaccination, and which of these patients require workups? Does a negative high sensitivity troponin or CRP rule out myocarditis? What is the role of PoCUS in the diagnosis and prognosis of myocarditis?

COVID-19 52

COVID-19 Pericarditis Cardiogenic Shock 52

Dr. Smith's ECG Blog

JUNE 17, 2018

I have always said that tachycardia should argue against acute MI unless there is cardiogenic shock or 2 simultaneous pathologies. PR depression, which suggests pericarditis 4. We also showed that, of 47 cases of pericarditis with ST elevation, none had ST depression in aVL. ) Absence of any ST depression in aVL. (

Chest Pain 52

Chest Pain Pericarditis Tachycardia Myocardial Infarction 52

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? The initial troponin I was 23.7 This was the 12-lead ECG. 3) Oliva et al. (4)

STEMI 52

STEMI Pericarditis Myocardial Infarction Cardiogenic Shock 52

Dr. Smith's ECG Blog

OCTOBER 8, 2023

The patient died of cardiogenic shock within 24 hours despite mechanical circulatory support. The axis is to the right and QRS complexes in lead I and aVL are predominantly negative suggesting LPFB. This patient at cath had a large CX occlusion with a massive troponin release. Troponin T >42.000ng/L.

Ischemia 112

Ischemia Chest Pain Cardiogenic Shock Cardiac Arrest 112

Dr. Smith's ECG Blog

JANUARY 15, 2024

Tachycardia is unusual for OMI, unless the patient is in cardiogenic shock (or getting close). The "flu-like" illness suggests myo- or pericarditis, but that would be a diagnosis of exclusion. The ECG has a lot of artifact, and the amplitude is very small, making interpretation challenging. The case continues.

Chest Pain 67

Chest Pain Blog Critical Care Arrhythmia 67