12 Lead ECG in acute pericarditis

12 Lead in ECG acute pericarditis

1. ACUTE PERICARDITIS ECG

2. Pericardium to pericarditis

3. INCIDENCE 90% of patients with acute pericarditis have ECG changes

4. Four stages< 50% of patients I II III IV

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. 12 Lead ECG in stage I

7. All the leads except

8. Except V1 and aVR

9. Stage II ST segment returns to baseline and flattening of T waves occurs, typically during several days

10. Stage III T-wave inversion occurs in stage III when ST segment is normal Sometimes with ST-segment depression

11. Stage IV ST segments and T waves return to normal Complete normalization may require weeks to months

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. Differential diagnosis Early repolarisation Acute STEMI

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. Acute STEMI ST elevation goes hand in hand with T wave inversion

16. With love