A 50-something Australian with sudden severe epigastric and chest pain presented looking extremely ill.

A 50-something with sudden severe epigastric and chest pain presented looking extremely ill.Here is her ECG:What do you think?There is ST Elevation in V2-V6, worrisome for ischemia.Or is it?Notice the very large R-waves and the very prominent J-point notching, with small S-waves.This is typical ofBenign T-wave Inversion, which is commonly seen in black patients of African heritage.This case was sent from Australia and the patient was aboriginal.  I have never heard of or seen benign T-wave inversion in Australian aboriginal blacks.The cath lab was activated and the patient was taken for angiogram, which was normal.The lipase returned at 16,000.  The patient had pancreatitis.One other tip:Pancreatitis often causes chest pain, but usually has severe epigastric tenderness; acute MI, though it may cause epigastric pain, usually does not have severe epigastric tenderness.If the patient did have severe tenderness, and you recognize this benign pattern on the ECG, then you would be dissuaded from activating the cath lab.If there was no other etiology of pain found, and you are not certain about the ECG, it is of course not wrong to activate the cath lab.In either pathology, the patient may appear very ill.The link above has 11 cases, one of which is this one (if you only want to read one):15 yo AAM with ST Elevation and T-wave Inversion. Hypertrophic Cardiomyopathy or Normal ( " Variant " )?
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs

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Source: Safety Science - Category: Occupational Health Source Type: research
Publication date: Available online 21 February 2020Source: Urology Case ReportsAuthor(s): Leila Haghighi, Mohsen Akbaribazm, Zahra Arab-Mazar, Mohsen RahimiAbstractHematobium species of this parasite tends to bladder and mesenteric arteries and it causes lesions in the bladder wall, urethra, and renal tubes. A 25-year-old man living in Tehran (a non-endemic and very rare area for schistosoma) suffers from symptoms such as hematuria with suprapubic pain, dysuria, fever, nausea and vomiting. Urine analysis showed a lot of red blood cells, after using cystoscopy of the area and receiving a bladder biopsy, a definitive diagnos...
Source: Urology Case Reports - Category: Urology & Nephrology Source Type: research
We report outcomes of our initial experience with LP in 38 children from 2 months of age. Materials and Methods From June 2015 to December 2017 38 children aged 2-60 months (mean age 1.7 years) underwent LP for correction of PUJ obstruction. The mean pre operative anteroposterior diameter of the renal pelvis (APD) was 43,5mm and all patients had hydronephrosis (APD 21.4-76 mm) and obstructed curve on diuretic renogram. Anderson-Hynes pyeloplasty was the performed technique. Results are reported. Results Mean operative time was 107 minutes (70-180) with no conversion to open procedure. Pain control was needed mainly in the ...
Source: International Braz J Urol - Category: Urology & Nephrology Source Type: research
We report outcomes of our initial experience with LP in 38 children from 2 months of age. Materials and Methods From June 2015 to December 2017 38 children aged 2-60 months (mean age 1.7 years) underwent LP for correction of PUJ obstruction. The mean pre operative anteroposterior diameter of the renal pelvis (APD) was 43,5mm and all patients had hydronephrosis (APD 21.4-76 mm) and obstructed curve on diuretic renogram. Anderson-Hynes pyeloplasty was the performed technique. Results are reported. Results Mean operative time was 107 minutes (70-180) with no conversion to open procedure. Pain control was needed mainly in the ...
Source: International Braz J Urol - Category: Urology & Nephrology Source Type: research
We report outcomes of our initial experience with LP in 38 children from 2 months of age. Materials and Methods From June 2015 to December 2017 38 children aged 2-60 months (mean age 1.7 years) underwent LP for correction of PUJ obstruction. The mean pre operative anteroposterior diameter of the renal pelvis (APD) was 43,5mm and all patients had hydronephrosis (APD 21.4-76 mm) and obstructed curve on diuretic renogram. Anderson-Hynes pyeloplasty was the performed technique. Results are reported. Results Mean operative time was 107 minutes (70-180) with no conversion to open procedure. Pain control was needed mainly in the ...
Source: International Braz J Urol - Category: Urology & Nephrology Source Type: research
We report outcomes of our initial experience with LP in 38 children from 2 months of age. Materials and Methods From June 2015 to December 2017 38 children aged 2-60 months (mean age 1.7 years) underwent LP for correction of PUJ obstruction. The mean pre operative anteroposterior diameter of the renal pelvis (APD) was 43,5mm and all patients had hydronephrosis (APD 21.4-76 mm) and obstructed curve on diuretic renogram. Anderson-Hynes pyeloplasty was the performed technique. Results are reported. Results Mean operative time was 107 minutes (70-180) with no conversion to open procedure. Pain control was needed mainly in the ...
Source: International Braz J Urol - Category: Urology & Nephrology Source Type: research
We report outcomes of our initial experience with LP in 38 children from 2 months of age. Materials and Methods From June 2015 to December 2017 38 children aged 2-60 months (mean age 1.7 years) underwent LP for correction of PUJ obstruction. The mean pre operative anteroposterior diameter of the renal pelvis (APD) was 43,5mm and all patients had hydronephrosis (APD 21.4-76 mm) and obstructed curve on diuretic renogram. Anderson-Hynes pyeloplasty was the performed technique. Results are reported. Results Mean operative time was 107 minutes (70-180) with no conversion to open procedure. Pain control was needed mainly in the ...
Source: International Braz J Urol - Category: Urology & Nephrology Source Type: research
We report outcomes of our initial experience with LP in 38 children from 2 months of age. Materials and Methods From June 2015 to December 2017 38 children aged 2-60 months (mean age 1.7 years) underwent LP for correction of PUJ obstruction. The mean pre operative anteroposterior diameter of the renal pelvis (APD) was 43,5mm and all patients had hydronephrosis (APD 21.4-76 mm) and obstructed curve on diuretic renogram. Anderson-Hynes pyeloplasty was the performed technique. Results are reported. Results Mean operative time was 107 minutes (70-180) with no conversion to open procedure. Pain control was needed mainly in the ...
Source: International Braz J Urol - Category: Urology & Nephrology Source Type: research
We report outcomes of our initial experience with LP in 38 children from 2 months of age. Materials and Methods From June 2015 to December 2017 38 children aged 2-60 months (mean age 1.7 years) underwent LP for correction of PUJ obstruction. The mean pre operative anteroposterior diameter of the renal pelvis (APD) was 43,5mm and all patients had hydronephrosis (APD 21.4-76 mm) and obstructed curve on diuretic renogram. Anderson-Hynes pyeloplasty was the performed technique. Results are reported. Results Mean operative time was 107 minutes (70-180) with no conversion to open procedure. Pain control was needed mainly in the ...
Source: International Braz J Urol - Category: Urology & Nephrology Source Type: research
We report outcomes of our initial experience with LP in 38 children from 2 months of age. Materials and Methods From June 2015 to December 2017 38 children aged 2-60 months (mean age 1.7 years) underwent LP for correction of PUJ obstruction. The mean pre operative anteroposterior diameter of the renal pelvis (APD) was 43,5mm and all patients had hydronephrosis (APD 21.4-76 mm) and obstructed curve on diuretic renogram. Anderson-Hynes pyeloplasty was the performed technique. Results are reported. Results Mean operative time was 107 minutes (70-180) with no conversion to open procedure. Pain control was needed mainly in the ...
Source: International Braz J Urol - Category: Urology & Nephrology Source Type: research
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