Chest pain with cardiovascular factors : OMI or not ?

Hello everyone,

Here is an interesting case of an old patient presenting with chest pain at home.

The pain was retrosternal, severe, with a hand on the chest.

Here is the ECG taken on site by the SMUR (mobile emergency and resuscitation service).

There was some doubt between occlusive myocardial infarction and pericarditis on the ECG.

The PM Cardio app did not detect STEMI / STEMI equivalent.

I then performed a transthoracic ultrasound (Philips Lumify) and found a partitioned pericardial effusion with no hemodynamic repercussions, reinforcing the diagnosis of pericarditis. The patient received 1000 mg of acetylsalicylic acid and a few milligrams of morphine without low molecular weight heparin, given the absence of coronary syndrome, and was admitted to the hospital for evaluation of pericarditis with pericardial effusion without tamponade.

Queen of Hearts did the job once again on my behalf.

Would you also have had doubts based on the ECG?

Do you use PM Cardio?

I look forward to hearing from you !

Frédéric Caruso, M.D