PericarditisCreated OnApril 18, 2020Last Updated OnOctober 28, 2020byadmin You are here: Main ECG Pericarditis < All Topics Table of Contents ECG findings: PR segment depression Widespread concave (‘saddle-shaped’) ST elevation Reciprocal ST depression and PR elevation in aVR and V1 Absence of reciprocal ST depression elsewhere TAKE HOME POINT: Sometimes it is difficult to differentiate STEMI and pericarditis, below are step to differentiate them, always consider STEMI before pericarditis ECG findings in Pericarditis vs. STEMI Step 1. Factors that strongly suggest STEMI: Reciprocal ST depression in any leads (except aVR & V1) Horizontal or convex upward ST-segment morphology STE in lead III > the STE in lead II Q-waves that you know are new (be cautious it they are old) Look for the factors that rule in STEMI before thinking pericarditis!  Step 2. Factors that suggest pericarditis (only after step 1): Pronounced PR-segment depression in multiple leads Friction rub Spodick sign Spodick’s Sign- Downsloping of the T-P segment

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