ECG Guru - Instructor Resources - Pericarditis https://www.ecgguru.com/ecg/pericarditis en Anterior Wall M.I. https://www.ecgguru.com/ecg/anterior-wall-mi-0 <div class="field field-name-field-ecg field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/ecg/anterior-wall-mi-0"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/AW102A.jpg" width="2147" height="509" alt="" /></a></div></div></div><div class="field field-name-field-ecg-interpretation field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even"><p><span style="font-size: 13.0080003738403px; line-height: 20.0063037872314px;">This ECG was taken from a 60 year old man who was complaining of severe substernal chest pain, radiating to his left arm and a non-productive cough.&nbsp; There was some initial discussion among the EMS crew &nbsp;about the possibility of the ECG showing a "<a title="BER ECG Guru" href="http://www.ecgguru.com/ecg/early-repolarization">benign early repolarization</a>" pattern because of the concave upward ("smiling") ST segments. &nbsp;They also considered a diagnosis of <a title="Pericarditis ECG Guru" href="http://www.ecgguru.com/ecg/pericarditis">pericarditis</a>, because the ST segments seem widespread. &nbsp;The baseline artifact makes it difficult to evaluate for PR segment depression or <a title="Spodicks Sign Dr. Mattu" href="http://www.mededmasters.com/pericarditis.html">Spodick's Sign</a>.</span></p><p><span style="font-size: 13.0080003738403px; line-height: 20.0063037872314px;">The patient's age (60 years) and troubling symptoms (chest pain radiating to the left arm) ruled out BEP for the paramedics. &nbsp;The ST segment elevations are pretty widespread - Leads V3, V4, V5, V6, I and II all show some STE. &nbsp;There are also "hyperacute" T waves in the leads with STE. &nbsp;There are ST abnormalities ranging from flattening of the shape to depression, but the bottom line is this patient is a <strong>60-year-old man with substernal chest pain radiating down his left arm!</strong></span></p><p><span style="font-size: 13.0080003738403px; line-height: 20.0063037872314px;">The patient was treated in the ambulance with chest pain protocols, and was transferred to a hospital with an interventional cath lab. &nbsp;The patient was conculusively diagnosed with an acute M.I. and underwent angioplasty.</span></p><p><span style="font-size: 13.0080003738403px; line-height: 20.0063037872314px;">This is a good ECG to demonstrate subtle changes when, combined with patient presentation, can help us diagnose a coronary event. &nbsp;It helps us emphasize that not all STEMIs will have dome-shaped, "tombstone" ST segments, and that patient symptoms, history, and age are important to consider.</span></p></div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/120/feed" method="post" id="fivestar-custom-widget" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--2" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give Anterior Wall M.I. 1/5</option><option value="40">Give Anterior Wall M.I. 2/5</option><option value="60">Give Anterior Wall M.I. 3/5</option><option value="80" selected="selected">Give Anterior Wall M.I. 4/5</option><option value="100">Give Anterior Wall M.I. 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >4</span></span> <span class="total-votes">(<span >1</span> vote)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-DfY-KIy-Z0OLCp28BZfFIFLBvkXEcQ2DqaGeLkHGRE8" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><div class="field field-name-field-taxonomy field-type-taxonomy-term-reference field-label-above"><div class="field-label">Related Terms:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/ecg/anterior-wall-mi-5" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Anterior wall M.I.</a></div><div class="field-item odd"><a href="/ecg/stemi" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">STEMI</a></div><div class="field-item even"><a href="/ecg/hyperacute-t-waves" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Hyperacute T waves</a></div><div class="field-item odd"><a href="/ecg/myocardial-infarction" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Myocardial infarction</a></div><div class="field-item even"><a href="/ecg/st-elevation" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">ST elevation</a></div><div class="field-item odd"><a href="/ecg/benign-early-repolarization" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Benign early repolarization</a></div><div class="field-item even"><a href="/ecg/pericarditis" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Pericarditis</a></div><div class="field-item odd"><a href="/ecg/spodicks-sign" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Spodick&#039;s sign</a></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_1"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fecg%2Fanterior-wall-mi-0&amp;title=Anterior%20Wall%20M.I."><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> <script type="text/javascript"> <!--//--><![CDATA[//><!-- if(window.da2a)da2a.script_load(); //--><!]]> </script></span></li> </ul> Mon, 09 Feb 2015 05:33:01 +0000 Dawn 621 at https://www.ecgguru.com https://www.ecgguru.com/ecg/anterior-wall-mi-0#comments Anterior Wall M.I. https://www.ecgguru.com/ecg/anterior-wall-mi <div class="field field-name-field-ecg field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/ecg/anterior-wall-mi"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/AW110.jpg" width="1800" height="484" alt="" /></a></div></div></div><div class="field field-name-field-ecg-interpretation field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even"><p>This ECG was obtained from an elderly man who was complaining of acute-onset chest pain, radiating down his left arm.&nbsp; He also complained of a cough, and had audible rhonchi.&nbsp; The machine interpretation gives several possible explanations for the widespread ST elevation noted on the ECG.&nbsp; The paramedics were a bit distracted by the machine's interpretation, and by the respiratory symptoms, and decided not to call a "cardiac alert" on the patient.&nbsp; They did, however, quickly transport him to the closest hospital, which happened to have full-service cardiac facilities.&nbsp; The patient was diagnosed&nbsp;with an acute M.I. and treated with angioplasty in the cath lab, with a good outcome.&nbsp; Afterward, the medics felt that they "overthought" this one, and should have given more weight to the patient's symptoms.&nbsp; Teach your students to evaluate their experiences with open minds and unafraid of self-criticism, so they may learn from every patient.&nbsp; This patient received excellent care, and the paramedics added to their "information banks", upon which they will draw for many years to come.&nbsp;</p><p>Although the angiogram results are not available to us, it is plausible that a proximal occlusion of the LCA, near the bifurcation of the LAD and the diagonal, could cause ST elevation in V3 through V6, with mild elevation in Lead II (which is oriented to the leftward portion of the inferior wall), and ST and T changes in the high lateral leads (I and aVL).&nbsp;</p><p>&nbsp;</p></div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/120/feed" method="post" id="fivestar-custom-widget--2" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--4" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give Anterior Wall M.I. 1/5</option><option value="40">Give Anterior Wall M.I. 2/5</option><option value="60">Give Anterior Wall M.I. 3/5</option><option value="80">Give Anterior Wall M.I. 4/5</option><option value="100" selected="selected">Give Anterior Wall M.I. 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >5</span></span> <span class="total-votes">(<span >2</span> votes)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit--2" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-uq5Ja0bWEgoKSM4VnHjenXLhJGHhrx8UYe1ilcZuzbw" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><div class="field field-name-field-taxonomy field-type-taxonomy-term-reference field-label-above"><div class="field-label">Related Terms:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/ecg/myocardial-infarction" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Myocardial infarction</a></div><div class="field-item odd"><a href="/ecg/stemi" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">STEMI</a></div><div class="field-item even"><a href="/ecg/anterior-wall-mi-5" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Anterior wall M.I.</a></div><div class="field-item odd"><a href="/ecg/pericarditis" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Pericarditis</a></div><div class="field-item even"><a href="/ecg/early-repolarization" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Early Repolarization</a></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_2"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fecg%2Fanterior-wall-mi&amp;title=Anterior%20Wall%20M.I."><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> </span></li> </ul> Sat, 02 Mar 2013 22:52:35 +0000 Dawn 410 at https://www.ecgguru.com https://www.ecgguru.com/ecg/anterior-wall-mi#comments Pericarditis https://www.ecgguru.com/ecg/pericarditis <div class="field field-name-field-ecg field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/ecg/pericarditis"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/M103.png" width="1800" height="960" alt="" /></a></div></div></div><div class="field field-name-field-ecg-interpretation field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even"><p>Today, we reprise an ECG originally published in 2012. &nbsp;We welcome comments and questions, and all questions will be answered by one of our experts.</p> <p>This 20-year-old man was feeling "sick", with a fever and malaise.&nbsp; He also complained of chest pain, which was partly relieved by sitting forward.&nbsp; He had a recent history of IV drug use.&nbsp; This ECG shows the tell tale signs of pericarditis: &nbsp;1) &nbsp;widespread ST elevation without the other signs of M.I. &nbsp;He has no T wave inversions, reciprocal ST depressions, or pathological Q waves. &nbsp; &nbsp;2) He has a subtle depression of his PR segments, which can be a difficult sign to see. &nbsp;3) <a title="Spodick's Sign Dr. Mattu" href="http://www.mededmasters.com/pericarditis.html">Spodick's Sign</a>, a downsloping of the RP segment.</p> <p>Additionally, his ST elevations are similar throughout the ECG, in height and in shape. &nbsp;Acute M.I. usually shows variations in the ST changes as we look closer to the center of the injury, or at the outskirts.</p> </div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/120/feed" method="post" id="fivestar-custom-widget--3" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--6" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give Pericarditis 1/5</option><option value="40">Give Pericarditis 2/5</option><option value="60">Give Pericarditis 3/5</option><option value="80">Give Pericarditis 4/5</option><option value="100" selected="selected">Give Pericarditis 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >4.2</span></span> <span class="total-votes">(<span >5</span> votes)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit--3" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-MWA4vRYRd9rcVnfi4LVKrzKu-2XnUKLL4snlX9jQ9XY" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><div class="field field-name-field-taxonomy field-type-taxonomy-term-reference field-label-above"><div class="field-label">Related Terms:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/ecg/pericarditis" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Pericarditis</a></div><div class="field-item odd"><a href="/ecg/st-elevation" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">ST elevation</a></div><div class="field-item even"><a href="/ecg/pr-depression" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">PR depression</a></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_3"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fecg%2Fpericarditis&amp;title=Pericarditis"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> </span></li> </ul> Wed, 27 Jun 2012 23:00:24 +0000 Dawn 241 at https://www.ecgguru.com https://www.ecgguru.com/ecg/pericarditis#comments