What are the stages of acute pericardial effusion on ECG?

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

Classically, the electrocardiographic changes of acute pericarditis evolve through 4 progressive stages, as follows:

  • Stage I - Diffuse ST-segment elevation and PR-segment depression

  • Stage II - Normalization of the ST and PR segments

  • Stage III - Widespread T-wave inversions: This is important to differentiate from myocardial infarction as T-wave inversions in pericarditis usually occur after ST-segment normalization, unlike myocardial infarction

  • Stage IV - Normalization of the T waves


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