Acute Pericarditis
Clinical characteristics of acute pericarditis:
- Mid-pleuritic chest pain
- Pain worsens with recumbency
- Pain relieved by leaning forward
- Pericardial friction may be present
- Most are idiopathic or viral in origin
ECG Clues suggestive of Acute Pericarditis:
- Diffuse ST-segment elevation concave up (except Leads avR,V1)
- ST-segment depression Leads avR, V1
- Diffuse PR-segment depression (except Leads avR, V1)
- May exhibit PR-segment elevation Leads avR, V1
- May mimic Acute STEMI or Benign Normal Variant (Early Repolarization)
- Lack of reciprocal ST-segment changes
- R-wave progression usually normal
- Quotient ST/T = mm of ST segment elevation / mm height of T-wave > 0.25 mm in Lead V6
PERICARDITIS Example A
Same Patient’s ECG 1 Year Prior: Example B
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