Ischemia Pericarditis Ultrasound 
Dr. Smith's ECG Blog
JUNE 20, 2018
Clinician and EKG machine read of acute pericarditis. While it is true that inferior MI has ST depression in aVL 99% of the time (Bischof and Smith), and that inferolateral ST elevation is the most common distribution for pericarditis, the ST elevation in V3 has "terminal QRS distortion (TQRSD)," (diagnostic of LAD occlusion).
Dr. Smith's ECG Blog
MARCH 26, 2024
There is also STE in lead III with reciprocal depression in aVL and I, as well as some subendocardial ischemia pattern with STD in V5-V6 and STE in aVR. Aslanger's is a combination of acute inferior OMI plus subendocardial ischemia, and due to the ischemia vectors , it has STE only in lead III. Now another, with ultrasound.
Dr. Smith's ECG Blog
DECEMBER 18, 2022
The differential is: Posterolateral OMI or subendocardial ischemia The distinction between posterior OMI and subendocardial ischemia can be important and sometimes difficult. Bedside ultrasound is another very important piece. Ischemic ST depression includes posterior OMI and subendocardial ischemia.
Dr. Smith's ECG Blog
JUNE 18, 2011
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.
Dr. Smith's ECG Blog
NOVEMBER 28, 2022
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. The second most common cause of medical cardiac tamponade is acute idiopathic pericarditis. This patient is only pseudo-stable. Her pulse is 125.
Dr. Smith's ECG Blog
JANUARY 9, 2023
Pericarditis? Beware a negative Bedside ultrasound. They still would not do angiography for her: See other cases of young patients with OMI: A 16 year old girl has syncope while playing basketball. Chest Pain in a Male in his 20's; Inferior ST elevation: Inferior lead "early repol" diagnosed. 24 yo woman with chest pain: Is this STEMI?
Dr. Smith's ECG Blog
OCTOBER 10, 2022
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. Now another, with ultrasound. The rhythm is atrial fibrillation. What is the Diagnosis?
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