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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Reference

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.