Pericarditis

Pericarditis is an inflammation of the pericardium. This can lead to ST elevation in all leads. Therefore, it is important to distinguish pericarditis from a myocardial infarction, which has more acute complaints and ST-elevations are limited to the infarct area.

Several stages of pericarditis

This enlargement shows clear PTa depression

The 12 lead ECG of this patient shows PTa depression, but no ST elevation

Another 12 lead example of pericarditis.

In pericarditis four stages can be distinguished on the ECG:

• stage I: ST elevation in all leads. PTa depression (depression between the end of the P-wave and the beginning of the QRS- complex)
• stage II: pseudonormalisation (transition)
• stage III: inverted T-waves
• stage IV: normalisation

Keep into account that in stage I pericarditis, ST-elevation is present in all leads except in aVR, V1 and III.