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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. 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. (
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? If detected early by ultrasound, the patient can be saved. 3) Oliva et al. (4)
Tachycardia is unusual for OMI, unless the patient is in cardiogenicshock (or getting close). A bedside ultrasound should be done to assess volume and other etiologies of tachycardia, but if no cause of type 2 MI is found, the cath lab should be activated NOW. We can see enough to make out that the rhythm is sinus tachycardia.
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