Wednesday, July 28, 2010
ECG manifestations of pericarditis, myocarditis, myopericarditis and endocarditis
The first three of these conditions can be difficult to distinguish from each other and from STEMI. Aside from the occasional classic ECG pattern of pericarditis, the diagnosis is based on a combination of ECG analysis (including serial tracings), clinical assessment and cardiac biomarkers. Sometimes nothing short of cardiac catheterization will reveal the answer. The ECG manifestations of endocarditis can be virtually anything. Conduction delays are characteristic although nonspecific, and are important only in predicting outcomes, not in making the diagnosis. According to a recent review in the American Journal of Emergency Medicine which covers the pathophysiology and provides illustrative tracings, some electrocardiographic patterns, although not specific, offer clues.