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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 ). Sinus tachycardia has many potential causes. This is especially true for the elderly patient with sinus tachycardia. What is the cause of the sudden tachycardia?
A previously healthy 53 yo woman was transferred to a receiving hospital in cardiogenicshock. Here was the ECG: There is sinus tachycardia. Well, don't we see diffuse ST Elevation in Myo-pericarditis (with STD in aVR)? This was sent by a reader. and K was normal. This is "Shark Fin" morphology. So this is STEMI, right?
There is sinus tachycardia. Sinus tachycardia, which exaggerates ST segments and implies that there is another pathology. I have always said that tachycardia should argue against acute MI unless there is cardiogenicshock or 2 simultaneous pathologies. PR depression, which suggests pericarditis 4.
The patient died of cardiogenicshock 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.
We can see enough to make out that the rhythm is sinus tachycardia. Tachycardia is unusual for OMI, unless the patient is in cardiogenicshock (or getting close). The "flu-like" illness suggests myo- or pericarditis, but that would be a diagnosis of exclusion. The case continues.
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