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 . 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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- 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.