Remove Ischemia Remove Pericarditis Remove Thrombosis
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ECG Blog #448 — A Young Man with Chest Pain.

Ken Grauer, MD

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. Causation of Endothelial damage is another potential mechanism of acute MI in a younger patient.

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

Dr. Smith's ECG Blog

In terms of ischemia, there is both a signal of subendocardial ischemia (STD max in V5-V6 with reciprocal STE in aVR) AND a signal of transmural infarction of the inferior wall with Q wave and STE in lead III with reciprocal STD in I and aVL. The rhythm is atrial fibrillation. The QRS complex is within normal limits. These include.

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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

Pericarditis? These include coronary artery spasm ( as may occur from cocaine use or binge alcohol drinking ) — myocardial bridging ( that may be the cause of intermittent acute ischemia ) — aberrant anatomy of a coronary artery ( which may present with sudden rupture causing acute infarction or sudden death at any age! ).