Pericarditis: PR Segment Displacement

Report:

Sinus rhythm 98/min

PR segment shift consistent with acute pericarditis

Otherwise normal trace

Comment:

The obvious ST segment shift of Stage I acute pericarditis106 was recorded 14 hours later (below). PR segment displacement is often the earliest sign, but is difficult to detect because it is merely an exaggeration of the normal pattern.

Trapezius ridge pain is very suggestive of pericarditis.

Further evolution is shown on the next two pages (Figs 151a, 151b).

151a. PR segments are still down the next day, exaggerating the independent ST segment elevation.

151b. Beginning of “T wave stage” of pericarditis, 10 days later. 151c. Widespread shallow T wave inversion, 7 weeks later

151d. Normalised ECG in 3 months. This patient did everything by the book 152. 30 year old lady with nausea and vomiting

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