文档介绍：Electrocardiographic Manifestations and
Differential Diagnosis of Acute Pericarditis
MARK A. MARINELLA, ., Wright State University School of Medicine, Dayton, Ohio
Acute pericarditis has many potential etiologies and typically presents as sharp central
chest pain that worsens with recumbency and is relieved by leaning forward. The
pathognomonic physical finding of acute pericarditis is the pericardial friction rub,
which is usually auscultated along the lower left sternal border. The electrocardiogram
(ECG) is a useful, simple tool that may aid in the diagnosis of acute pericarditis. Typi-
cal ECG findings include diffuse concave-upward ST-segment elevation and, occasion-
ally, PR-segment depression. ECG changes of both acute myocardial infarction and early
repolarization can appear similar to ECG changes of acute pericarditis. However, these
conditions can usually be excluded by an accurate history, physical examination and
recognition of a few key features on the ECG.
cute pericarditis is the most carditis. These conditions monly
common disease state affecting include acute myocardial infarction and early
the pericardium. Most cases of repolarization. Since these and other conditions
acute pericarditis are idiopathic require distinctly different treatments, physi-
or have a viral ,2 Other cians should be able to recognize the typical
poten