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Pericarditis

Dr. Sanjay Gupta

Pericarditis refers to inflammation of the pericardium The pericardium is a sac within which the heart sits. Acute inflammation of this sac is known as acute pericarditis. About 5% of patients who present to A+E with chest pain which is not deemed to be a heart attack or angina are ultimately diagnosed with pericarditis.

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Transient STEMI, serial ECGs prehospital to hospital, all troponins negative (less than 0.04 ng/ml)

Dr. Smith's ECG Blog

1.196 x STE60 in V3 in mm) + (0.059 x computerized QTc) - (0.326 x RA in V4 in mm) Third, one can do an immediate cardiac ultrasound. This rules out pericarditis, which essentially never has reciprocal ST depression. A bedside ultrasound was done by an emergency physician and simultaneously read by a cardiologist.

STEMI 52
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Another deadly triage ECG missed, and the waiting patient leaves before being seen. What is this nearly pathognomonic ECG?

Dr. Smith's ECG Blog

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. This is a quiz.

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A woman in her 70s with chest pain

Dr. Smith's ECG Blog

It was notable for a normal cardiac ultrasound with no pericardial fluid, normal LV and RV function (though the quality was not sufficient to evaluate for wall motion abnormalities) and normal IVC dynamics. Bedside ultrasound is another very important piece. Ultrasound can be very helpful to distinguish causes of hypotension.

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A woman in her 20s with syncope

Dr. Smith's ECG Blog

A bedside cardiac ultrasound was performed with a parasternal long axis view demonstrated below: There is a large pericardial effusion with collapse of the right ventricle during systole. She was discharged after a short hospitalization with oncology and cardiology follow-up. This patient is only pseudo-stable.

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A teenager with chest pain, a troponin below the limit of detection, and "benign early repolarization"

Dr. Smith's ECG Blog

He was then transferred to quaternary care childrens hospital. Pericarditis? Beware a negative Bedside ultrasound. No apical thrombus noted using Definity contrast. Coxsackie serologies negative. Covid PCR negative. UDS positive for marijuana only. 24 yo woman with chest pain: Is this STEMI?

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A man in his 30s with cardiac arrest and STE on the post-ROSC ECG

Dr. Smith's ECG Blog

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. Now another, with ultrasound. This patient arrested shortly after hospital arrival.