What is the role of ECG in the workup of pericardial effusion?

Updated: Nov 28, 2018
  • Author: William J Strimel, DO, FACP; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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Answer

Early in the course of acute pericarditis, the ECG typically displays diffuse ST elevation in association with PR depression (see the image below). The ST elevation is usually present in most leads except for aVR, although in postmyocardial infarction pericarditis, the changes may be more localized. (Patients with uremic pericarditis frequently do not have the typical electrocardiographic abnormalities.)

This electrocardiogram (ECG) is from a patient wit This electrocardiogram (ECG) is from a patient with malignant pericardial effusion. The ECG shows diffuse low voltage, with a suggestion of electrical alternans in the precordial leads.

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