Pericarditis Stenosis Stents 
Dr. Smith's ECG Blog
JULY 3, 2018
Submitted and written by Alex Bracey with edits by Pendell Meyers and Steve Smith Case A 50ish year old man with a history of CAD w/ prior LAD MI s/p LAD stenting presented to the ED with chest pain similar to his prior MI, but worse. Remember, pericarditis is the thing you say and write down when youre actively trying to miss an OMI.
Dr. Smith's ECG Blog
MAY 29, 2024
His disease included 70% prox LAD, 80% distal LAD, 10% in-stent stenosis in the distal LCX, 70% OM1, 70% OM2, and 60% prox RCA. Triage ECG: It was interpreted as lateral STEMI, and he was sent to the cath lab, where the angiogram showed unchanged CAD from known prior, with no acute culprit. Three troponins were undetectable.
Dr. Smith's ECG Blog
JANUARY 28, 2018
There is evidence that de Winter's T-waves really represent a tiny trickle of blood through the thrombotic stenosis. Both were stented. In patients with suspicion of acute MI who have any ST elevation, aVL is also a very useful lead to differentiate between pericarditis and MI. Subsequent echo showed no wall motion abnormality.
Dr. Smith's ECG Blog
SEPTEMBER 9, 2024
The cardiologist called this 20% stenosis. You can easily imagine this patient getting one of several diagnoses -- vasospasm, MINOCA , pericarditis, or maybe even no diagnosis at all beyond "non-obstructive coronary artery disease." The operator documented thoughtful consideration of risks and benefits of stent placement.
Dr. Smith's ECG Blog
JUNE 28, 2019
60-something with h/o MI and stents presented with chest pain radiating to the back and nausea/vomiting. Pericarditis? The cath lab was activated: Result: Thrombotic 95% stenosis at the ostium of a small LPL2 with 70% stenosis at the LPL2/LPDA bifurcation in the distal/AV groove Cx Tubular 70% stenosis in the mid-circumflex. (In
Dr. Smith's ECG Blog
NOVEMBER 1, 2022
The 50-something patient with history of coronary stenting and slightly reduced LV ejection fraction. In the setting of prior stenting and reduced left ventricular ejection fraction, would pursue a heart team revascularization approach Syntax score 28.5, Pericarditis would be even more unlikely in someone without chest pain.
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