The following ECG is from a 30 yr old male who presented with a 48 hour history of positional left sided chest pain. He is normally fit and well.
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- PR – Normal (~200ms)
- QRS – Normal (100ms)
- QT – 340ms (QTc Bazette 400 ms)
- ST Elevation leads I, II, III, aVF, V1-6
- ST Depression lead aVR
- PR depression globally (expect aVL & aVR)
- Clinical history and ECG features consistent with pericarditis
- Potential element of underlying BERP – no old ECG’s to compare
What happened ?
The patient had negative serial troponins and an echo which did not show a pericardial effusion. A diagnosis of uncomplicated pericarditis was made and he was discharged with NSAIDs.
Pericarditis has multiple causes including:
- Infective – viral, bacterial, fungal, TB
- Auto-immune – SLE
- Post myocardial infarction
- Post surgical
- Post radiotherapy
- Drug induced
References / Further Reading
Life in the Fast Lane
- Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.
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