Which ECG findings in the evaluation of acute pericarditis are characteristic of underlying cardiovascular disorders?

Updated: Apr 02, 2019
  • Author: Sean Spangler, MD; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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Regional ECG changes may be present in infarction-associated pericarditis. If the pericardial involvement is confined to the infarction zone, stage 1 ECG findings are often not seen. Positive T waves that last longer than 48 hours after an acute MI or premature reversal of inverted T waves may indicate pericardial involvement. An ST-segment–to–T-wave ratio of 0.25 or more in lead V6 helps distinguish acute pericarditis from early repolarization.

In Dressler syndrome, ECG findings may demonstrate diagnostic changes of acute pericarditis, especially if the ECG findings normalize after the infarction.

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