DSAE STEMI Review, Mod 2: Acute Pericarditis

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



Same Patient’s ECG  1 Year Prior:  Example B

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