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Old 06-20-2011
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EKG Can you diagnose this ECG?

A 59-year-old woman presents to the emergency room complaining of chest pain. As part of her diagnostic evaluation, a 12-lead electrocardiogram (ECG) is recorded. The tracing is displayed in the figure. Which of the following diagnoses is best supported by these ECG abnormalities?

Can you diagnose this ECG?-ekg.jpg
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Answer Choices
A. Acute pulmonary embolism (PE)
B. Hyperkalemia
C. Pericarditis
D. Subendocardial myocardial infarction
E. Transmural myocardial infarction
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Old 06-20-2011
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Default C. pericarditis

Diffuse ST segment elevation.

ST segment depression in AVR.

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Old 06-20-2011
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i think he is tachycardic too i dont think is b or c..D?

ver interesting question
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Old 06-20-2011
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C. Pericarditis (Saddle-shaped diffuse ST elevation and PR depression)
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Old 06-20-2011
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since its diffuse st elevation its pericardities so ans is c....since d or e occurs only in regional st elevation...plz correct me if iam wrong
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Option C (Pericarditis) is correct. This is a typical electrocardiogram in pericarditis, showing diffuse ST segment elevation.

Option A (Acute pulmonary embolism [PE]) is incorrect. Most common ECG abnormalities of PE are tachycardia and nonspecific ST-T–wave abnormalities The classic finding of right-heart strain is demonstrated by an S1-Q3-T3 pattern.

Option B (Hyperkalemia) is incorrect. The ECG does not show discrete peaking of T waves; instead there is diffuse ST segment elevation, which is typical for pericarditis.

Option D (Subendocardial myocardial infarction) is incorrect. ST segment depression indicates acute myocardial injury. This is a typical ECG seen in pericarditis, showing diffuse ST segment elevation.

Option E (Transmural myocardial infarction) is incorrect. The ECG shows diffuse ST segment elevation, most likely reflecting pericarditis. A transmural myocardial infarction would show regional Q waves, ST depression, and reciprocal changes in the ECG.

High-yield Hit 1
Echocardiogram to detect and determine amount of pericardial effusion; absence of effusion does not rule out the diagnosis of pericarditis. Divergence of right and left ventricular systolic pressures is present in cardiac tamponade and constrictive pericarditis.
ECG: varies with the evolutionary stage of pericarditis
Acute phase: diffuse ST-segment elevations (particularly evident in the precordial leads), which can be distinguished from acute MI by:
Absence of reciprocal ST-segment depression in oppositely oriented leads (reciprocal ST-segment depression may be seen in aVR and VI)
Elevated ST segments concave upward
Absence of Q waves
Intermediate phase: return of ST segment to baseline, and T wave inversion in leads previously showing ST-segment elevation (Fig. 1-178)
Late phase: resolution of the T wave changes
Chest radiography
Cardiac silhouette appears enlarged if more than 250 ml of fluid has accumulated
Calcifications around the heart may be seen with constrictive pericarditis
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  #7  
Old 06-20-2011
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of course Pericarditis
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Cardiology-, EKGs-, Internal-Medicine-, Step-2-Questions

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