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She was diagnosed with pericarditis and spent one day in the hospital without events. Much more classic findings of pericarditis. 1 week later (about 1 week prior to the tamponade visit) she had a follow up outpatient visit and this ECG was recorded: Appears to show resolving findings. mm STE depression in aVL.
Hopefully a repeat echocardiogram will be performed outpatient. 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. 1900: RBBB and LAFB are almost fully resolved. ST depression.
Dyspnea, Chest pain, Tachypneic, Ill appearing: Bedside Cardiac Echo gives the Diagnosis 31 Year Old Male with RUQ Pain and a History of Pericarditis. When the ECG differential is between OMI on the one hand, and PE/type II OMI on the other, the absence of VT/VF strongly favors PE. Submitted by a Med Student, with Great Commentary on Bias!
It is relevant to note here that as a physician active clinically in both the inpatient and outpatient arenas, I am an eyewitness to the severe toll COVID19 took on my patients in the Spring or 2020. There are also case reports of severe morbidity and mortality from vaccine myocarditis resulting in critical illness or death.
But vasovagal syncope typically has a prodrome such that further evaluation of today's patient may be needed as an outpatient to better assess for the cause of his sudden syncope. Smith : I recognize this as a STEMI mimic. I was not alarmed. The providers showed me the ECG and I told them that I thought it was a fake.
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