New Electrocardiographic Criteria to Differentiate Acute Pericarditis and Myocardial Infarction

Abstract

Patients with acute STEMI, but not those with acute pericarditis, show prolongation of QRS complex and shortening of QT interval in ECG leads with ST-segment elevation. These new findings may improve the differential diagnostic yield of the classical ECG criteria.

Electrocardiographic approach to classification of acute pericarditis in emergency department: Typical and atypical pericarditis

“…analyzed the patients with acute pericarditis and acute ST-segment elevation myocardial infarction. They reported that ≥ 7 leads with ST-segment elevation and ≥ 0 leads with PR-segment depression had 85.9% sensitivity and 85.3% specificity (15). Moreover, they found PR-segment depression in other leads was a more important indicator than PR-segment elevation in aVR lead.…”

Triangular QRS-ST-T Waveform Electrocardiographic Pattern in Acute Myopericarditis: A Case Report from a Limited-Resources Hospital

“…A closer evaluation of the ECG before the TW pattern appeared ( Figure 1 ) also showed a diffused concave-up ST-segment elevation pattern and PR-segment depression in leads II, III, aVF, and V3-V4, and reciprocal PR-segment elevation and ST-segment depression in aVR, which is a pathognomonic finding for pericarditis [ 4 ]. The QRS duration when the ST-segment elevation occurred ( Figure 1 ) was also not prolonged (120 ms) compared to the normal baseline ECG ( Figure 4 ), which indicates an epicardial rather than transmural myocardial injury [ 11 , 12 ].…”

Typical pericarditis ECG findings after falling from height. The PR segment depression or ST segment elevation?

“… 10 The ECG of acute STEMI shows prolonged QRS duration and shortened QT-interval in leads with ST-segment elevation. 11 …”