Dr. Anish Koka

JANUARY 1, 2023

The case reports Case 1 involves a 26 year old man who developed pericarditis after the Pfizer vaccine. Pericarditis, an inflammation of the sac the heart lives in, developed about 7 days after the Pfizer vaccine. She has had multiple repeat hospital presentations and 2 months later continues to be symptomatic.

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Dr. Smith's ECG Blog

JULY 12, 2020

They informed me that she had just been hospitalized 10 days ago for "some fluid around the heart" and was discharged after one day without incident. Ultimately, she spent several days in the hospital and no further fluid collected. She was diagnosed with pericarditis and spent one day in the hospital without events.

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Dr. Smith's ECG Blog

OCTOBER 17, 2022

Pericarditis? If you were thinking that this is pericarditis, that would be possible in the absence of any clinical information. However, there is zero PR depression which would be VERY unusual in pericarditis. P.S.: Acute pericarditis may produce diffuse ST elevation. Presence of STD is helpful; absence is not.

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All About Cardiovascular System and Disorders

APRIL 10, 2024

Prolonged chest pain calls for early hospitalization and you have to attend the hospital emergency room. Driving alone to the hospital should be avoided at all costs as it can be catastrophic. Another type of pain originating from the heart is due to an inflammation of its covering known as pericarditis.

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Dr. Smith's ECG Blog

AUGUST 6, 2024

These latter findings are typical of pericarditis, but pericarditis never has reciprocal ST depression. Despite active CP — cath lab activation was deferred and this patient was transported to a local hospital without PCI capability. Usually with pericarditis and myocarditis — hyperacute T waves (HATW) are not present.

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Dr. Smith's ECG Blog

DECEMBER 10, 2019

He was seen at another hospital and found to have a slightly elevated troponin, then underwent a CT pulmonary angiogram (PE) protocol which revealed a right sided pneumonia. Echo does not necessarily differentiate acute MI from pericarditis: both may have wall motion abnormalities. He was treated with Ceftriaxone and azithromycin.

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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.

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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. Between 81-95% of life-threatening ventricular dysrhythmias and acute cardiac failure occur within 24-48 hours of hospitalization.

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Circulation: Arrhythmia and Electrophysiology

DECEMBER 21, 2023

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) years, colchicine did not reduce a composite of emergency department visit, cardiovascular hospitalization, cardioversion, or repeat ablation (29 versus 25 per 100 patient-years; HR, 1.18 [95% CI, 0.69–1.99];P=0.55).CONCLUSIONS:Colchicine

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Dr. Smith's ECG Blog

JUNE 17, 2024

Given his exertional chest pain and elevated troponin, the patient was admitted to the hospital for "NSTEMI" with a plan for left heart catheterization the next day. Dyspnea, Chest pain, Tachypneic, Ill appearing: Bedside Cardiac Echo gives the Diagnosis 31 Year Old Male with RUQ Pain and a History of Pericarditis.

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Dr. Smith's ECG Blog

NOVEMBER 25, 2017

On day 3 of hospitalization she underwent coronary angiography, revealing a 95% lesion in the mid-LAD which was stented. The second troponin I returned elevated at 6.4, and for some reason there were no more troponins measured after that. One can say with full confidence that is was completely occluded at the time of the presentation ECG.

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Dr. Smith's ECG Blog

FEBRUARY 16, 2020

A previously healthy 53 yo woman was transferred to a receiving hospital in cardiogenic shock. Well, don't we see diffuse ST Elevation in Myo-pericarditis (with STD in aVR)? This was sent by a reader. and K was normal. Here was the ECG: There is sinus tachycardia. This is "Shark Fin" morphology. So this is STEMI, right? Which artery?

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Ken Grauer, MD

SEPTEMBER 21, 2024

Pericarditis is rare — but myocarditis is not , so especially in this age group — more information is needed to quickly determine if this could be an acute MI, myocarditis, or none of the above. The patient arrested outside the hospital. Unfortunately — the cardiologist at that center did not recognize the abnormal ECG findings.

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Global Cardiac Surgery

SEPTEMBER 17, 2018

To perform these interventions, a team of 8 Ngaliema Clinic staff went to Christian Barnard Memorial Hospital, Cape Town where they were trained by Dr Susan Vosloo. Two diasporan members of AFMED have been operating patients at the Monkole Hospital Centre and Kinshasa University Clinic during the summer.

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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. He arrived to our hospital one hour later.

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Dr. Anish Koka

JUNE 5, 2023

The KDCA also established a reporting system with a legal obligation for special adverse events including myocarditis and pericarditis after COVID-19 vaccination. While there have been case reports published of severe VRM, Israeli and US data found no severe cases in their published series.

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Dr. Smith's ECG Blog

NOVEMBER 28, 2022

She was discharged after a short hospitalization with oncology and cardiology follow-up. The second most common cause of medical cardiac tamponade is acute idiopathic pericarditis. Fluid samples were sent for culture and cytology and results showed malignant cells. A repeat POCUS showed resolution of her pericardial effusion.

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Dr. Smith's ECG Blog

OCTOBER 10, 2022

He spent almost 2 months in the hospital, and reportedly made a full neurologic recovery. Dyspnea, Chest pain, Tachypneic, Ill appearing: Bedside Cardiac Echo gives the Diagnosis 31 Year Old Male with RUQ Pain and a History of Pericarditis. This patient arrested shortly after hospital arrival. He was prescribed apixaban.

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Dr. Smith's ECG Blog

OCTOBER 11, 2020

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. We have countless cases of missed posterior MI on this blog, including these: Interventionalist at the Receiving Hospital: "No STEMI, no cath.

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Dr. Smith's ECG Blog

MARCH 3, 2023

Another handy section is for troponin levels and their delta cut-offs, which can be modified according to the kit used in your hospital. We would like to thank Muzaffer Değertekin, MD, PhD, Prof. President Elect) and Bülent Mutlu, MD, Prof. Associate General Secretary ) of Turkish Society of Cardiology, for their support.

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Ken Grauer, MD

APRIL 23, 2023

To Emphasize: When the patient is older and presents with a history of cardiac-sounding chest pain — then acute infarction will be much more common than acute pericarditis, myocarditis, or perimyocarditis. F ollow- U p in T oday's C ASE: The patient in today's case was diagnosed as having acute myocarditis.

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Dr. Smith's ECG Blog

MARCH 11, 2019

You do NOT see this in normal variant STE, nor in pericarditis. After admission to the hospital, the patient was discharged from the hospital without any investigation of his acute MI. Here is the computer interpretation: (Veritas algorithm) This is what I said: "This is diagnostic of an acute inferior MI.

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Dr. Smith's ECG Blog

DECEMBER 18, 2022

Further Reading: [link] See these relevant cases: A man in his 50s with acute chest pain and diffuse ST depression "Pericarditis" strikes again Is it important to recognize LVH Pseudo-infarction patterns? Wonderfully, she has returned to her normal life with no significant co-morbidities from her dissection.

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Dr. Smith's ECG Blog

JULY 19, 2019

Amazingly, he did not suffer any serious complication in hospital. This is the most important exception to the classic teaching of "diffuse STE without reciprocal depression is less likely ACS, more likely pericarditis". He recovered and was discharged several days later. Long term follow up is unknown at this point.

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Dr. Smith's ECG Blog

JANUARY 9, 2023

He was then transferred to quaternary care childrens hospital. Pericarditis? No apical thrombus noted using Definity contrast. Coxsackie serologies negative. Covid PCR negative. UDS positive for marijuana only. There, troponins were trended up to 100,000 ng/L (still unknown if troponin I or T). Beware a negative Bedside ultrasound.

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Circulation

NOVEMBER 11, 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

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Dr. Anish Koka

FEBRUARY 20, 2023

4 An accompanying editorial 5 notes “Data from COVID-Heart provide reassuring evidence that myocarditis, once predicted to be an emerging public health crisis attributable to COVID-19, is relatively uncommon even among hospitalized patients and is less virulent than predicted during the early days of the pandemic.

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Dr. Smith's ECG Blog

DECEMBER 5, 2023

Written by Kirsten Morrissey, MD with edits by Bracey, Grauer, Meyers, and Smith An older teen was transferred from an outside hospital with elevated serum troponin and and ECG demonstrating ST elevations. The workup at the transferring hospital yielded elevated troponin I at 18.1 Acute coronary syndrome in a pediatric patient?

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