How to Distinguish Myocardial Infarction from Pericarditis on ECG

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    COVID 19 and Heart Conditions

    In this video, Roger Seheult, MD of MedCram discusses the Lancet study regarding Covid 19 and myocardial infarction (heart attack). The study finds that COVID 19 is an associated risk factor for myocardial infarction. He notes COVID 19 vaccines have also had an increased risk in associated pericarditis.  

    Myocardial Infarction vs. Pericarditis

    However, there are differences in the ECG between a myocardial infarction vs. pericarditis. He shows classic ECG examples of each. The differences between the two are critical to distinguish quickly as a myocardial infarction needs immediate treatment. This can include coronary angiography or tPA (tissue plasminogen activator).

    In pericarditis, the pericardium (covering around the heart) is inflamed. This can cause fluid to collect around the heart. Treatment for a myocardial infarction such as tPA if given mistakenly to someone who has pericarditis can cause life-threatening symptoms. tPA should not be given in pericarditis but only in myocardial infarction if clinically indicated.  A bedside point of care ultrasound can help determine if there are any segmental wall motion abnormalities or fluid collection around the heart. 

    ECG and Ultrasound

    Distinguishing the difference between a patient with myocardial infarction or pericarditis on ECG and ultrasound can have a significant clinical impact.  



    MI (Wikimedia) |…

    Pericarditis (Wikimedia) |…

    COVID-19 and myocardial infarction (Lancet) |…

    Medcram  ECG Interpretation explained clearly

    Medcram Ultrasound Principles & Instrumentation Explained Clearly

    Medcram E Fast (Focused Assessment with Sonography in Trauma) exam explained clearly


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