Pericarditis on ECG
February 15th, 2021
Overview
The electrocardiogram is a useful tool in the diagnosis of pericarditis, which can often present with chest pain that is similar in nature to an acute coronary syndrome.
The important distinguishing factor on ECG is the fact that the ST elevation affects all leads (i.e. is global), as opposed to the localised ST elevation in myocardial infarction. PR depression is also a characteristic finding.
ECG Findings in Pericarditis
- Widespread concave (saddle-shaped) ST elevation (may not be present in aVR or V1)
- PR depression
- T wave changes - flattening then inversion
Stages of ECG Findings in Pericarditis
- Stage I - widespread concave ST elevation
- Stage II - resolution of ST elevation, T wave flattening
- Stage III - T wave inversion
- Stage IV - resolution of T wave inversion
Causes of Pericarditis
- Infection - viral, bacterial, tuberculous, fungal
- Autoimmune - lupus, rheumatoid arthritis
- Post myocardial infarction
- Neoplastic
- Uraemic pericarditis
- Myxoedema
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