Stage One ST segment deviations are virtually diagnostic of acute pericarditis when typically distributed among limb and precordial ECG tracings. Atypical ECG responses include absence of ST deviations, which conceals the diagnosis, and restricted distribution of ST deviations, which suggests myocardial injury. Among 44 consecutive patients with acute pericarditis, 19 (43%) had atypical ECGs. Although all 19 had a pericardial rub, eight had no ST deviations in the limb leads and seven developed no ST changes, including three with no ECG abnormalities of any kind. Patients with typical ECGs by ST segment criteria were more likely to progress to T wave inversion. PR segment deviations occurred in 14 patients with typical, and 14 with atypical ECGs. In four of the latter, the PR segment shifts were the only ECG sign. Presence or absence of heart disease and etiology of pericarditis could not be statistically associated with particular electrocardiographic responses.

Acute Disease↗

PubMed1980

Pericardial disorders occurring during open-label study of 1,869 severely hypertensive patients treated with minoxidil.

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Adolescent↗

PubMed1980

Responses of peak ear-pulse derivative to changing left ventricular function.

The ear densitograph displacement pulse derivative (dD/dtear) is the analog of the arterial pressure derivative (dP/dt) and behaves comparably under a variety of cardiocirculatory challenges. Technical reliability and uniform application of the transducer are advantages that make it ideal for intrasubject monitoring. With atrial fibrillation as a model of functional variability in eight subjects, peak dD/dtear (P) tracked echocardiographic stroke volume, ejection fraction, ejection rate, and velocity of circumferential fiber shortening quite closely with the exception of some values in three subjects, two of whom had mitral regurgitation and one paradoxic septal movement. In all subjects, P showed good to excellent correlations with cycle length, preejection period (PEP), LVET (left ventricular ejection time), and PEP/LVET. The method appears to be ideally suited to intrasubject monitoring for changing ventricular function.

Adolescent↗

PubMed1980