Remove Pericarditis Remove STEMI Remove Tachycardia
article thumbnail

Acute chest pain and ST Elevation. CT done to look for aortic dissection.

Dr. Smith's ECG Blog

This ECG together with these symptoms is certainly concerning for OMI, but the ECG is not fully diagnostic, and another consideration could be acute pericarditis. Mistaking OMI for pericarditis is a much more harmful error than the converse. The rate is tachycardic, which is uncommon in OMI and common in pericarditis.

article thumbnail

"Pericarditis" strikes again

Dr. Smith's ECG Blog

mm has been described in normal subjects) Overall impression: In my opinion and experience, this ECG most likely represents a normal baseline ECG, but with a small chance of pericarditis instead. I texted this to Dr. Smith without any information, and this was his reply: "This could be pericarditis but probably is normal variant."

article thumbnail

Why the sudden shock after a few days of malaise?

Dr. Smith's ECG Blog

This is a value typical for a large subacute MI, n ormal value 48 hours after myocardial infarction is associated with Post-Infarction Regional Pericarditis ( PIRP ). Sinus tachycardia has many potential causes. This is especially true for the elderly patient with sinus tachycardia. What is the cause of the sudden tachycardia?

article thumbnail

A man in his late 30s with acute chest pain and ST elevation

Dr. Smith's ECG Blog

Sent by Dan Singer MD, written by Meyers, edits by Smith A man in his late 30s presented with acute chest pain and normal vitals except tachycardia at about 115 bpm. There is a reasonable chance of pericarditis in this case, or this could be a baseline." And this is because OMI is frequently misdiagnosed as pericarditis.

article thumbnail

Unconscious + STEMI criteria: activate the cath lab?

Dr. Smith's ECG Blog

ECG met STEMI criteria and was labeled STEMI by computer interpretation. J waves can also be induced by Occlusion MI (5), STEMI mimics including takotsubo and myocarditis complicated by ventricular arrhythmias (6, 7), and subarachnoid hemorrhage with VF (8). Take home : Not all STEs are STEMIs or OMIs. What do you think?

STEMI 52
article thumbnail

Chest Pain and Inferior ST Elevation.

Dr. Smith's ECG Blog

There is sinus tachycardia. Sinus tachycardia, which exaggerates ST segments and implies that there is another pathology. I have always said that tachycardia should argue against acute MI unless there is cardiogenic shock or 2 simultaneous pathologies. PR depression, which suggests pericarditis 4.

article thumbnail

Three prehospital ECGs in patients with chest pain

Dr. Smith's ECG Blog

These latter findings are typical of pericarditis, but pericarditis never has reciprocal ST depression. It definitely does not fulfill STEMI criteria, and I would argue that it would not lead to cath lab activation in most centers. Usually with pericarditis and myocarditis — hyperacute T waves (HATW) are not present.