12 Lead ECG in acute pericarditis

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12 Lead in ECG acute pericarditis

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12 Lead ECG in acute pericarditis

  1. 1. ACUTE PERICARDITIS ECG
  2. 2. Pericardium to pericarditis
  3. 3. INCIDENCE • 90% of patients with acute pericarditis have ECG changes
  4. 4. Four stages< 50% of patients • I • II • III • IV
  5. 5. Stage I • Sinus tachycardia is common • ST-segment elevation in all leads except aVR and V1 • Normal T-wave axis • PR-segment depression • ST segment is usually concave upward • No regional lead distributions
  6. 6. 12 Lead ECG in stage I
  7. 7. All the leads except
  8. 8. Except V1 and aVR
  9. 9. Stage II • ST segment returns to baseline and flattening of T waves occurs, typically during several days
  10. 10. Stage III • T-wave inversion occurs in stage III when ST segment is normal • Sometimes with ST-segment depression
  11. 11. Stage IV • ST segments and T waves return to normal • Complete normalization may require weeks to months
  12. 12. Variation • Classical changes may not go through each of these phases in an individual case • PR-segment depression has been reported in about 80% of patients • PR-segment depression is one of the earliest electrocardiographic • Manifestations of pericarditis, occurring in the first few hours of presentation and often preceding ST-segment elevation • Ventricular tachycardia and conduction abnormalities are suggestive of myocardial involvement with ischemia(Myopericarditis)
  13. 13. Differential diagnosis • Early repolarisation • Acute STEMI
  14. 14. Normal variant of early repolarisation The ST-segment elevation of pericarditis can be differentiated from the normal variant of early repolarization if the ratio of ST to T wave in V6 is greater than 25%
  15. 15. Acute STEMI • ST elevation goes hand in hand with T wave inversion
  16. 16. With love

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