The document summarizes the ECG presentation and clinical signs of acute pericarditis, including constant dull chest pain and the presence of a pericardial rub. It outlines the evolution of RWMA over 2-4 weeks and testing recommendations to rule out myopericarditis. Treatment recommendations include NSAIDs and colchicine, while avoiding steroids.

1. ACUTE PERICARDITIS
ECG

2. Presentation
• Constant dull aching chest pain

3. On examination
• Look for rub

5. Echo
• For pericardial effusion
• RWMA

6. EVOLUTION :2-4 WEEKS
STAGES PR SEGMENT ST SEGMENT T WAVE
I DEPRESSION ELEVATION AND UPWARD
COVING
UPRIGHT
II NORMAL NORMAL NORMAL OR FLATTENED
III NORMAL NORMAL T INVERTED
IV NORMAL NORMAL NORMAL

7. If T inversion persists
• Do troponin and CPK-MB to rule myopericarditis

8. Treatment of acute pericarditis
• No steroid
• Yes to NSAID
• Yes to Colchicin