Characteristics Of Electrocardiogram In Acute Pericarditis

Acute pericarditis is an inflammatory condition affecting the pericardium, and its diagnosis often involves identifying specific electrocardiogram (ECG) changes. These ECG alterations largely depend on the extent and severity of myocardial involvement beneath the epicardium.

Key ECG Features Of Acute Pericarditis

One of the hallmark signs of acute pericarditis is ST-segment elevation. This elevation typically appears in a concave upward pattern across multiple leads, specifically in all 12 standard leads except for aVR. Additionally, early T waves may appear tall and prominent during the acute phase.

Progression Of ECG Changes

Over the course of several days, the ST segments gradually return to the baseline isoelectric line. This is followed by flattening or inversion of the T waves, which may persist for weeks or even months. Eventually, the T waves tend to normalize, marking the resolution of the acute phase.

Additional ECG Findings

In the presence of pericardial effusion, ECG may reveal low QRS voltage. When the effusion is significant, electrical alternans—a phenomenon where the QRS complex alternates in amplitude—can be observed. Importantly, unlike myocardial infarction, acute pericarditis does not present with pathological Q waves.

Another common observation is sinus tachycardia, which reflects the body's response to inflammation and pericardial irritation. These combined ECG features are crucial for distinguishing pericarditis from other cardiac conditions, particularly acute coronary syndromes.