Cardiology MCQ – ECG changes in pericarditis – Answer

Cardiology MCQ – ECG changes in pericarditis – Answer

ECG changes in pericarditis are due to involvement of:

Correct answer: 3. Visceral pericardium (epicardium) and adjacent myocardium

Parietal pericardium is electrically silent [1]. In pericarditis, 4 stages of ECG changes have been described:

Stage 1: PR segment depression and ST segment elevation in leads other than aVR and V1 (oriented to the cavity)

Stage 2: ST becomes isoelectric

Stage 3: T waves get inverted

Stage 4: ECG normalizes

It may be noted that unlike in the evolution of myocardial infarction ST segment elevation does not co-exist with T wave inversion.

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  1. Chiabrando JG, Bonaventura A, Vecchié A, Wohlford GF, Mauro AG, Jordan JH, Grizzard JD, Montecucco F, Berrocal DH, Brucato A, Imazio M, Abbate A. Management of Acute and Recurrent Pericarditis: JACC State-of-the-Art Review. J Am Coll Cardiol. 2020;75(1):76-92.