Remove Cardiomyopathy Remove Pericarditis Remove Tachycardia
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Does this T wave pattern mean anything?

Dr. Smith's ECG Blog

An Initial ECG was performed: Initial ECG: Sinus tachycardia with prolonged QT interval (QTc of 534 ms by Bazett). She was admitted to the ICU where subsequent ECGs were performed: ECG at 12 hours QTc prolongation, resolution of T wave alternans ECG at 24 hours Sinus tachycardia with normalized QTc interval. No ischemic ST changes.

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A 53 yo woman with cardiogenic shock. Believe me, this is not what you think.

Dr. Smith's ECG Blog

Here was the ECG: There is sinus tachycardia. Well, don't we see diffuse ST Elevation in Myo-pericarditis (with STD in aVR)? I have summarized the m ajor e tiologic c ategories of acute myocarditis and inflammatory cardiomyopathies. This was sent by a reader. and K was normal. This is "Shark Fin" morphology. Which artery?

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A woman in her 20s with syncope

Dr. Smith's ECG Blog

The ECG shows sinus tachycardia, a narrow, low voltage QRS with alternating amplitudes, no peaked T waves, no QT prolongation, and some minimal ST elevation in II, III, and aVF (without significant reciprocal STD or T wave inversion in aVL). It is difficult to tell if there is collapse during diastole due to the patient’s tachycardia.

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

Dr. Smith's ECG Blog

Other than tachycardia, Other than slight tachycardia, vitals were within normal limits (including oxygen saturation). 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.

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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. Pacing Clin Electrophysiol 2008 Choi SH, Lee OH, Yoon G-S, et al.

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