2015•Unpublished venueRequires access
ACUTE PERICARDITIS
Roland X. Stroobandt MD, PhD, FHRS, S. Serge Barold MD, FRACP, FACP, FACC, FESC, FHRS, Alfons F. Sinnaeve Ing. MSc
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Abstract
The ECG is useful in the diagnosis of acute pericarditis, with abnormalities found in approximately 90% of cases. The ST segment elevation in acute pericarditis is usually “concave”, compared with the “convex” appearance of the ST segment in the acute injury stage of a myocardial infarction (MI). Acute myocardial infarction may generate Q waves or loss of R wave voltage in the precordial leads. Reciprocal changes are absent in acute pericarditis, but frequent with acute MI. Early repolarization is distinguished by ST segment elevation limited to the precordial leads, elevation of the ST segment in V1, an isoelectric ST segment in lead V6 and notching of the terminal aspect of the QRS complex. A pattern of ST segment elevation similar to early repolarization may be seen in patients with myocardial infarction. Acute myocarditis can cause diffuse ST segment elevation, as does pericarditis.