Circulation and Pericarditis - Cardiovascular Update

Why the sudden shock after a few days of malaise?

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. Sinus tachycardia has many potential causes. Hammill SC.

Cardiogenic Shock

Cardiogenic Shock Chest Pain Pericarditis Myocardial Infarction

What are the possible mechanisms of simultaneous Inferior and Anterior STEMI?

Dr. S. Venkatesan MD

MAY 16, 2024

RCA-dependent LAD circulation through collaterals 3. Mid or Proximal LAD lesion with proximal thrombus build-up Further possibilities Mimickers: Distal LAD lesions -Inferior ST elevation due to sparing of diagonal Wrong diagnosis -ERS pattern, pericarditis etc. Wrap around LAD true Global MI 2.

STEMI

STEMI Pericarditis Embolism Circulation

Case Report: Heart aneurysm of unknown origin in a two-year-old child diagnosed in the course of Multisystem Inflammatory Syndrome in Children

Frontiers in Cardiovascular Medicine

MARCH 12, 2024

Another consideration is an ischemic lesion that may have resulted from impaired coronary circulation during the complicated course of MIS-C. Additionally, a complication of pericarditis cannot be entirely ruled out. It is possible that this disturbance resolved spontaneously before aortography was performed.

Aneurysm

Aneurysm Pericarditis Congenital Stenosis

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Prevalence of Pericardial Late Gadolinium Enhancement in Patients After Cardiac Surgery: Clinical and Histological Correlations

Circulation: Cardiovascular Imaging

NOVEMBER 20, 2023

Circulation: Cardiovascular Imaging, Volume 16, Issue 11 , Page e015606, November 1, 2023. BACKGROUND:Pericardial late gadolinium enhancement (LGE) is usually associated with active pericarditis, but it is not infrequently found in patients after cardiac surgery even a long time after the intervention.

Pericarditis

Pericarditis Cardiovascular Imaging Circulation

Colchicine to Prevent Atrial Fibrillation Recurrence After Catheter Ablation: A Randomized, Placebo-Controlled Trial

Circulation: Arrhythmia and Electrophysiology

DECEMBER 21, 2023

Circulation: Arrhythmia and Electrophysiology, Ahead of Print. Postablation chest pain consistent with pericarditis was reduced with colchicine (4% versus 15%; HR, 0.26 [95% CI, 0.09–0.77];P=0.02) BACKGROUND:Inflammation may promote atrial fibrillation (AF) recurrence after catheter ablation. mg twice daily or placebo for 10 days.

Atrial Fibrillation

Atrial Fibrillation Ablation Chest Pain Atrial Flutter

Does this T wave pattern mean anything?

Dr. Smith's ECG Blog

OCTOBER 23, 2023

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.

Tachycardia

Tachycardia Cardiac Arrest ICU Blog

A teenager involved in a motor vehicle collision with abnormal ECG

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

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. Circulation: Cardiovascular Imaging. Massive Transfusion for Motorcycle Collision with Hemorrhage, Troponin Elevated. Cramer, M.

Tachycardia

Tachycardia Dysrhythmia Atrial Fibrillation Bradycardia

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

Dr. Smith's ECG Blog

JUNE 28, 2019

Pericarditis? A straight ST segment virtually never happens in inferior ST elevation that is NOT due to OMI (normal variant, pericarditis) 4. 60-something with h/o MI and stents presented with chest pain radiating to the back and nausea/vomiting. Time zero What do you think? There is inferior ST elevation. Is it normal variant?

Chest Pain

Chest Pain Pericarditis Stents Stent

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

Dr. Smith's ECG Blog

NOVEMBER 1, 2022

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.

Chest Pain

Chest Pain Coronary Artery Bypass Graft Pericarditis Blog

Biosense Webster Submits Application to U.S. FDA Seeking Approval of the VARIPULSE Platform for the Treatment of Paroxysmal Atrial Fibrillation

DAIC

MARCH 28, 2024

Primary adverse events were defined as myocardial infarction, thromboembolism, transient ischemic attack, diaphragmatic paralysis, pneumothorax, heart block, pulmonary edema, vagal nerve injury, pericarditis, major vascular access complication or bleeding, death, stroke, or any other cerebrovascular accident. Circulation Research.

Atrial Fibrillation

Atrial Fibrillation AFIB Ablation Pulmonary

Subacute AnteroSeptal STEMI, With Persistent ST elevation and Upright T-waves

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? Circulation 1993;88(3):896-904. 3) Oliva et al. (4) Lessons : 1. Hammill SC.

STEMI

STEMI Pericarditis Myocardial Infarction Cardiogenic Shock

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

Dr. Smith's ECG Blog

MARCH 11, 2016

Post-infarction Regional Pericarditis (PIRP) PIRP happens when MI is transmural, all the way from subendocardium to subepicardium, thus leading to inflammation of the subepicardium (next to the pericardium). MYOCARDIAL RUPTURE AND POSTINFARCTION REGIONAL PERICARDITIS KEY POINTS · Myocardial rupture occurs in 1 to 1.5% Re-occlusion 2.

Myocardial Infarction

Myocardial Infarction Pericarditis STEMI Angina

Large Transmural STEMI with Myocardial "Rupture" of Ventricular Septum

Dr. Smith's ECG Blog

JULY 7, 2013

When there is MI extending all the way to the epicardium (transmural), that infarcted epicardium is often inflamed (postinfarction regional pericarditis, or PIRP). 3) strongly associated myocardial rupture with postinfarction regional pericarditis (PIRP) , and associated PIRP with persistent upright T-waves. 3) Oliva et al. (3)

STEMI

STEMI Myocardial Infarction Pericarditis Ultrasound

Occlusion myocardial infarction is a clinical diagnosis

Dr. Smith's ECG Blog

DECEMBER 11, 2023

Recall from this post referencing this study that "reciprocal STD in aVL is highly sensitive for inferior OMI (far better than STEMI criteria) and excludes pericarditis, but is not specific for OMI." Circulation , 130 (25). St depression in lead AVL differentiates inferior st-elevation myocardial infarction from pericarditis.

Myocardial Infarction

Myocardial Infarction Chest Pain STEMI Blood Pressure

Pulsed Field Ablation Using Focal Contact Force–Sensing Catheters for Treatment of Atrial Fibrillation: 1-Year Outcomes of the ECLIPSE AF Study

Circulation: Arrhythmia and Electrophysiology

DECEMBER 19, 2024

Circulation: Arrhythmia and Electrophysiology, Ahead of Print. There were no incidences of adverse event fistula, diaphragmatic paralysis, MI, pericarditis, thromboembolism, PV stenosis, transient ischemic attack, or death. BACKGROUND:Pulsed field ablation (PFA) is a promising treatment for atrial fibrillation.

Atrial Fibrillation

Atrial Fibrillation Ablation Arrhythmia Outcomes

Abstract 4139677: A rare case of ventriculobronchial fistula caused by an epicardial defibrillator patch

Circulation

NOVEMBER 11, 2024

Circulation, Volume 150, Issue Suppl_1 , Page A4139677-A4139677, November 12, 2024. Postoperative recovery was successful, with no further hemoptysis, and the patient was discharged to a rehabilitation facility.Discussion:EPDs are no longer used due to high failure rates and complications like scar formation and constrictive pericarditis.

Defibrillator

Defibrillator Cardiac Arrest Sudden Cardiac Death Coronary Angiogram

Abstract 4141403: Age-, Sex- and/or Ethnic- specific disparities; Biventricular systolic and diastolic strain, and biomarker, prognostic implications in Acute Tuberculous Pericarditis.

Circulation

NOVEMBER 11, 2024

Circulation, Volume 150, Issue Suppl_1 , Page A4141403-A4141403, November 12, 2024. To-date no larger studies have assessed sub-clinical myocardial mechanics in acute tuberculous pericarditis (ATBP) and age/sex/ethnic differences, and synergistic-prognostic association of these parameters with patients' outcomes (survival).Aim:To

Pericarditis

Pericarditis Biomarkers Heart Failure Outcomes

OMI in a pediatric patient? Teenagers do get acute coronary occlusion, so don't automatically dismiss the idea.

Dr. Smith's ECG Blog

DECEMBER 5, 2023

Though less prevalent in younger patients, occlusion MI may occur and requires the same early interventions as older patients. - - Pericarditis and myocarditis should be a diagnosis of exclusion. Circulation. Erratum in: Circulation. 2021 Aug 10;144(6):e123-e135. doi: 10.1161/CIR.0000000000001001. 0000000000001001. 2015.12.073.

Pediatrics

Pediatrics Pericarditis COVID-19 Congenital Heart Disease

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

Dr. Smith's ECG Blog

FEBRUARY 26, 2025

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.

Chest Pain

Chest Pain Pericarditis Myocardial Infarction Dementia

Why the sudden shock after a few days of malaise?

What are the possible mechanisms of simultaneous Inferior and Anterior STEMI?

Case Report: Heart aneurysm of unknown origin in a two-year-old child diagnosed in the course of Multisystem Inflammatory Syndrome in Children

Webinars

Prevalence of Pericardial Late Gadolinium Enhancement in Patients After Cardiac Surgery: Clinical and Histological Correlations

Colchicine to Prevent Atrial Fibrillation Recurrence After Catheter Ablation: A Randomized, Placebo-Controlled Trial

Does this T wave pattern mean anything?

A teenager involved in a motor vehicle collision with abnormal ECG

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

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

Biosense Webster Submits Application to U.S. FDA Seeking Approval of the VARIPULSE Platform for the Treatment of Paroxysmal Atrial Fibrillation

Subacute AnteroSeptal STEMI, With Persistent ST elevation and Upright T-waves

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

Large Transmural STEMI with Myocardial "Rupture" of Ventricular Septum

Occlusion myocardial infarction is a clinical diagnosis

Pulsed Field Ablation Using Focal Contact Force–Sensing Catheters for Treatment of Atrial Fibrillation: 1-Year Outcomes of the ECLIPSE AF Study

Abstract 4139677: A rare case of ventriculobronchial fistula caused by an epicardial defibrillator patch

Abstract 4141403: Age-, Sex- and/or Ethnic- specific disparities; Biventricular systolic and diastolic strain, and biomarker, prognostic implications in Acute Tuberculous Pericarditis.

OMI in a pediatric patient? Teenagers do get acute coronary occlusion, so don't automatically dismiss the idea.

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

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