Remove Circulation Remove Ischemia Remove Pericarditis
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Why the sudden shock after a few days of malaise?

Dr. Smith's ECG Blog

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. Sinus tachycardia has many potential causes. Hammill SC.

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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. Circulation. The described rhythm was an irregular, wide complex rhythm. JAMA Intern Med. 2017.3191.

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Initial Reperfusion T-waves, Followed by Pseudonormalization. Diagnosis?

Dr. Smith's ECG Blog

More likely, the patient had crescendo angina, with REVERSIBLE ischemia for 48 hours that only became potentially irreversible (STEMI) at that point in time. During the 48 hours of angina, such reversible ischemia often leads to myocardial stunning with akinesis of the myocardial wall that puts it at risk for thrombus. Re-occlusion 2.

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A teenager involved in a motor vehicle collision with abnormal ECG

Dr. Smith's ECG Blog

The ECG shows sinus tachycardia with RBBB and LAFB, without clear additional superimposed signs of ischemia. ECG of pneumopericardium and probable myocardial contusion shows typical pericarditis Male in 30's, 2 days after Motor Vehicle Collsion, complains of Chest Pain and Dyspnea Head On Motor Vehicle Collision. ST depression.

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Inferior Subtle ST elevation: straight ST segment, but also no reciprocal ST depression in aVL: which is more important?

Dr. Smith's ECG Blog

Pericarditis? For coronary anatomy, see here: [link] This is the post intervention ECG: All ST Elevation is gone (more proof that it was all a result of ischemia) Formal Echo: Normal estimated left ventricular ejection fraction - 55%. More likely, these T waves probably reflect ischemia of uncertain age. Is it normal variant?

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Opiate overdose, without chest pain or shortness of breath. Cognitive dissonance.

Dr. Smith's ECG Blog

Of course this depends on many factors: 1) duration of occlusion, 2) whether full or near occlusion with zero flow or some flow -- the flow in the artery is the critical factor, measured by "TIMI" flow, 3) presence of collateral circulation and others. Pericarditis would be even more unlikely in someone without chest pain.

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Chest pain followed by 6 days of increasing dyspnea -- what happened?

Dr. Smith's ECG Blog

The exception is with postinfarction pericarditis , in which a completed transmural infarct results in inflammation of the subepicardial myocardium and STE in the distribution of the infarct, and which results in increased STE and large upright T-waves. These findings together are more commonly seen with pericarditis.