Pericarditis Stent 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
AUGUST 6, 2024
These latter findings are typical of pericarditis, but pericarditis never has reciprocal ST depression. This led to immediate cath lab activation — which revealed total occlusion of a large 1st diagonal branch that was stented. == Below is the ECG of Patient #3 — recorded from a 35-year old man with sudden, new-onset CP.
Dr. Smith's ECG Blog
SEPTEMBER 9, 2024
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
MARCH 27, 2025
Below is the first ECG, signed off by the over-reading cardiologist agreeing with the computer interpretation: ST elevation, consider early repolarization, pericarditis, or injury. Theres ST elevation in V3-4 which meets STEMI criteria, which could be present in either early repolarization, pericarditis or injury. What do you think?
Dr. Smith's ECG Blog
NOVEMBER 25, 2017
On day 3 of hospitalization she underwent coronary angiography, revealing a 95% lesion in the mid-LAD which was stented. Repeat ECG the next morning: Resolution of findings above, as well as new deep T-wave inversions in V3-V6 and inferior leads, consistent with reperfusion.
Dr. Smith's ECG Blog
NOVEMBER 29, 2023
Of course the patient was saddled with the erroneous "pericarditis" diagnosis after CTs ruled also ruled out PE and dissection. The patient was found to have total "mid" LAD occlusion which was stented: Pre-PCI. Serial ECGs remained unchanged. Echo showed normal EF and no wall motion abnormalities, and no pericardial effusion.
Expert insights. Personalized for you.
52 
Let's personalize your content