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Chapter 11: THE RESTING ELECTROCARDIOGRAM PERICARDITIS

The ECG pattern of acute (generalized) pericarditis not due to MI is produced by the associated epimyocarditis, which in turn results in diffuse epicardial "injury."6 The ST segments can be elevated in all leads except aV^ and, rarely, in V| (B+-0- Fig. 11-11). Symmetric T-wave inversion (due to epicardial "ischemia") usually develops after the ST segments have returned to the baseline (but can appear during the injury stage).6 Neither reciprocal ST-segment changes nor abnormal Q waves are seen. In most cases of acute pericarditis, the PR segment is depressed (see -H i Fig. 11-11). Average ECG resolution occurs in close to 2 weeks.!! The ECG pattern of acute pericarditis has to be differentiated from the normal variant referred to as early repolarization (see Fig. 11-4).

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