HIV induced pericarditis electrocardiogram: Difference between revisions
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==Overview== | |||
Acute [[pericarditis]] can mimic myocardial infarction (STEMI) signs and electrocardiogram and present with chest pain and cardiac enzyme (bio-marker) elevation the differentiation is made by specific features. | |||
==Electrocardiogram== | ==Electrocardiogram== | ||
*Acute [[pericarditis]] can mimic myocardial infarction (STEMI) signs and electrocardiogram and present with chest pain and cardiac enzyme (bio-marker) elevation.<ref name="Castellanos1997">{{cite journal|last1=Castellanos|first1=Agustin|title=Electrocardiography in Clinical Practice: Adult and Pediatric, Fourth Edition. By T. Chou. W.B. Saunders, Philadelphia (1996) 729 pages, illustrated, $99.00 ISBN: 0721656471|journal=Clinical Cardiology|volume=20|issue=5|year=1997|pages=505–505|issn=01609289|doi=10.1002/clc.4960200521}}</ref> | *Acute [[pericarditis]] can mimic myocardial infarction (STEMI) signs and electrocardiogram and present with chest pain and cardiac enzyme (bio-marker) elevation.<ref name="Castellanos1997">{{cite journal|last1=Castellanos|first1=Agustin|title=Electrocardiography in Clinical Practice: Adult and Pediatric, Fourth Edition. By T. Chou. W.B. Saunders, Philadelphia (1996) 729 pages, illustrated, $99.00 ISBN: 0721656471|journal=Clinical Cardiology|volume=20|issue=5|year=1997|pages=505–505|issn=01609289|doi=10.1002/clc.4960200521}}</ref> | ||
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[[Image:PulsusAlternans.jpg|center|500px]] | [[Image:PulsusAlternans.jpg|center|500px]] | ||
Copyleft image obtained courtesy of ECGpedia | '''Copyleft image obtained courtesy of ECGpedia''' <ref>http://en.ecgpedia.org</ref> | ||
==References== | ==References== | ||
Latest revision as of 02:43, 18 December 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ramyar Ghandriz MD[2]
Overview
Acute pericarditis can mimic myocardial infarction (STEMI) signs and electrocardiogram and present with chest pain and cardiac enzyme (bio-marker) elevation the differentiation is made by specific features.
Electrocardiogram
- Acute pericarditis can mimic myocardial infarction (STEMI) signs and electrocardiogram and present with chest pain and cardiac enzyme (bio-marker) elevation.[1]
- IF pericarditis does not follow myocarditis and vice versa, the differentiation is made as following:[2][3][4]
- Morphology:
- Distribution:
- Pericarditis shows a non-specific ST-elevation pattern while STEMI shows specific changes based on the infarction location.
- Reciprocal changes:
- Concurrent ST and T wave changes:
- Pericarditis is not followed by ST-segment elevation and T wave.
- Those changes are pretty common in STEMI.
- PR segment:
- Pericarditis shows PR elevation in aVR with PR depression in other leads because of atrial injury.
- STEMI does not show such changes.
- Other signs:
- Hyperacute T waves
- New pathologic Q waves
- QT prolongation
- These signs are rarely seen in acute pericarditis
- Shown below is an EKG with the presence of micro-voltage and electrical alternans suggesting pericardial effusion and cardiac tamponade.
Copyleft image obtained courtesy of ECGpedia [5]
References
- ↑ Castellanos, Agustin (1997). "Electrocardiography in Clinical Practice: Adult and Pediatric, Fourth Edition. By T. Chou. W.B. Saunders, Philadelphia (1996) 729 pages, illustrated, $99.00 ISBN: 0721656471". Clinical Cardiology. 20 (5): 505–505. doi:10.1002/clc.4960200521. ISSN 0160-9289.
- ↑ Spodick DH (1976). "Differential characteristics of the electrocardiogram in early repolarization and acute pericarditis". N Engl J Med. 295 (10): 523–6. doi:10.1056/NEJM197609022951002. PMID 950958.
- ↑ Ginzton LE, Laks MM (1982). "The differential diagnosis of acute pericarditis from the normal variant: new electrocardiographic criteria". Circulation. 65 (5): 1004–9. doi:10.1161/01.cir.65.5.1004. PMID 7074735.
- ↑ Klatsky AL, Oehm R, Cooper RA, Udaltsova N, Armstrong MA (2003). "The early repolarization normal variant electrocardiogram: correlates and consequences". Am J Med. 115 (3): 171–7. doi:10.1016/s0002-9343(03)00355-3. PMID 12935822.
- ↑ http://en.ecgpedia.org