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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. The diagnosis was made based on classic findings of inflammation on an electrocardiogram associated with acute chest pain.
The pediatric team felt it might be ACS, but on review of his prior ECGs, it was thought to be really unchanged from the 2 prior and more consistent with myocarditis. Echo does not necessarily differentiate acute MI from pericarditis: both may have wall motion abnormalities. What I find interesting here is the new Q-wave in lead III.
It is seldom done in pediatric age group. They include myocardial ischemia, acute pericarditis, pulmonary embolism, external compression due to mass over the right ventricular outflow tract region, and metabolic disorders like hyper or hypokalemia and hypercalcemia. With proper precautions, risk can be reduced.
Acute coronary syndrome in a pediatric patient? An ECG was perfomed on arrival to our ED: NSR with ST elevation II,III, aVF with reciprocal depression in aVL Would you refer this pediatric patient for emergent PCI? World J Pediatr. The workup at the transferring hospital yielded elevated troponin I at 18.1 Epub 2021 May 20.
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