Cardiology

Question 1

How does pericarditis present on ECG

Answer 1

the changes in pericarditis are often global/widespread, as opposed to the ‘territories’ seen in ischaemic events

‘saddle-shaped’ ST elevation

PR depression: most specific ECG marker for pericarditis

Question 2

Causes of acute pericarditis

Answer 2

viral infections (Coxsackie)
tuberculosis
uraemia

post-myocardial infarction
early (1-3 days): fibrinous pericarditis
late (weeks to months): autoimmune pericarditis (Dressler’s syndrome)

radiotherapy

connective tissue disease
systemic lupus erythematosus
rheumatoid arthritis

hypothyroidism

malignancy
lung cancer
breast cancer

trauma

Question 3

STEMI criteria

Answer 3

clinical symptoms consistent with ACS (generally of ≥ 20 minutes duration) with persistent (> 20 minutes) ECG features in ≥ 2 contiguous leads of:
2.5 mm (i.e ≥ 2.5 small squares) ST elevation in leads V2-3 in men under 40 years, or ≥ 2.0 mm (i.e ≥ 2 small squares) ST elevation in leads V2-3 in men over 40 years
1.5 mm ST elevation in V2-3 in women
1 mm ST elevation in other leads
new LBBB (LBBB should be considered new unless there is evidence otherwise)