Dr. Smith's ECG Blog

DECEMBER 13, 2019

mm has been described in normal subjects) Overall impression: In my opinion and experience, this ECG most likely represents a normal baseline ECG, but with a small chance of pericarditis instead. I texted this to Dr. Smith without any information, and this was his reply: "This could be pericarditis but probably is normal variant."

Pericarditis 52

Pericarditis Chest Pain Aortic Blog 52

Dr. Smith's ECG Blog

JUNE 17, 2024

He was started on a heparin drip and CTA of the chest was ordered to rule out pulmonary embolism. Echocardiogram showed severe RV dilation with McConnell’s sign and an elevated RVSP. Electrocardiographic Differentiation Between Acute Pulmonary Embolism and Acute Coronary Syndromes on the Basis of Negative T Waves - ScienceDirect.

Chest Pain 139

Chest Pain Embolism Pulmonary Tachycardia 139

Dr. Smith's ECG Blog

JANUARY 15, 2024

The "flu-like" illness suggests myo- or pericarditis, but that would be a diagnosis of exclusion. While awaiting transfer to the cath lab, STAT echocardiogram was performed and showed LVEF 30-35%, as well as anterior, inferior, and apical hypokinesis, and apical thrombus. The case continues. The thrombus is circled below in red.

Chest Pain 64

Chest Pain Blog Arrhythmia Critical Care 64

Dr. Smith's ECG Blog

FEBRUARY 16, 2025

Despite apparently hearing the above history together with two diagnostic ECGs and a troponin compatible with OMI, the cardiologist thought the ECG represented pericarditis and recommended echocardiogram. Echocardiogram was finally performed five hours after the first diagnostic ECG. Here is the wall motion diagram.

STEMI 72

STEMI Pericarditis Chest Pain Echocardiogram 72