Document Pericarditis Stent 
Dr. Smith's ECG Blog
JULY 3, 2018
Submitted and written by Alex Bracey with edits by Pendell Meyers and Steve Smith Case A 50ish year old man with a history of CAD w/ prior LAD MI s/p LAD stenting presented to the ED with chest pain similar to his prior MI, but worse. Remember, pericarditis is the thing you say and write down when youre actively trying to miss an OMI.
Dr. Smith's ECG Blog
MARCH 27, 2025
Below is the first ECG, signed off by the over-reading cardiologist agreeing with the computer interpretation: ST elevation, consider early repolarization, pericarditis, or injury. Theres ST elevation in V3-4 which meets STEMI criteria, which could be present in either early repolarization, pericarditis or injury. What do you think?
Dr. Smith's ECG Blog
SEPTEMBER 9, 2024
You can easily imagine this patient getting one of several diagnoses -- vasospasm, MINOCA , pericarditis, or maybe even no diagnosis at all beyond "non-obstructive coronary artery disease." The operator documented thoughtful consideration of risks and benefits of stent placement. At the time of IVUS, there was no thrombus.
Dr. Smith's ECG Blog
JUNE 28, 2019
60-something with h/o MI and stents presented with chest pain radiating to the back and nausea/vomiting. Pericarditis? It was stented. A straight ST segment virtually never happens in inferior ST elevation that is NOT due to OMI (normal variant, pericarditis) 4. The patient had a p rior h istory of MI + stents.
Dr. Smith's ECG Blog
NOVEMBER 13, 2022
This is a bad ST vector orientation, because it causes widespread STE and one of the most important mistakes that needs to be avoided here is thinking of the diagnosis of pericarditis. Such an out-of-proportion STE is virtually never seen in pericarditis. Look at the STE in lead II, aVF. Smith's Blog show this same phenomenon ).
Dr. Smith's ECG Blog
JULY 19, 2019
This prompted a repeat ECG (we do not have documentation from that time to tell us whether he had persistent, recurrent, or absent pain): Progression of anterior OMI to full Q-wave MI with large pathologic Q-waves in V2-V4 with persistent STE which now meets STEMI criteria (after full thickness infarction/stunning). ng/mL (very elevated).
Dr. Smith's ECG Blog
DECEMBER 11, 2023
Triage documented a complaint of left shoulder pain. 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." Here is the angiogram after stent placement. link] Bischof, J. Worrall, C.,
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