ELECTROCARDIOGRAPHIC PATTERNS IN ACUTE PERICARDITIS: EVOLUTION, CAUSES AND DIAGNOSTIC SIGNIFICANCE OF PATTERNS IN LIMB AND CHEST LEADS; A STUDY OF FIFTY-SEVEN CASES

From time to time various changes have been shown to develop in the electrocardiograms of patients with acute pericarditis.1Often these have been striking, consisting in the main of diminished amplitude of the ventricular complex in the presence of effusion, inversion of the T wave and elevation of the RST segment. In studying fifty-seven cases of acute pericarditis of different etiologic types we encountered changes of this type sufficiently often to lead us to feel that striking alterations of the electrocardiogram frequently develop in cases of acute pericardial disease and that in a certain percentage of cases they may assume a pattern that is distinctive enough to have diagnostic value. In the present paper we wish to describe these changes and to discuss their cause. MATERIAL The varieties of pericarditis represented in our series of fifty-seven cases were varied and included the following etiologic types: rheumatic pericarditis (thirteen cases),