급성 심장막염에서 나타나는 PR 분절 하강과 ST 분절 상승에 대한 고찰

Abstract

Purpose: Depression of the PR-segment is very specific of acute pericarditis and represents subepicardial atrial injury due to pericardial inflammation. And the ST-segment elevation that occurs during acute pericarditis shows usually upwardly concave appearance, and helps distinguish pericarditis from early repolarization and acute myocardial infarction. Our purpose of this study was to investigate the relation and feature of these two findings.

Methods:We conducted a 7-year retrospective study of acute pericarditis patients, who visited to our center between January 2001 and December 2007. All standard initial 12-lead electrocardiography were examined and compared the electrocardiographic findings according to the first symptom time. And if the electrocardiography shows only PR-segment depression, electrocardiographic change was investigated.

Results:Thirteen patients included in this study. 5 patients had only PR-segment depression (group 1), 3 patients had both PR-segment depression and ST-segment elevation (group 2), 2 patients had only ST-segment elevation (group 3) and 3 patients had no PR-segment and ST-segment deviation (group 4) on initial 12-lead electrocardiography. The mean times from the onset of symptoms to the first ECG were 6.80± 5.4, 188±56.7, 40±21.2, 263±205.5 hours. 3 patients showed ST-segment elevation among 5 patients, who had only PR-segment depression on the first electrocardiography.

Conclusion: PRsegment depression is the initial electrocardiographic finding in acute pericarditis and can precede ST-segment elevation. PR-segment depression and classic ST-segment change are important in diagnosing acute pericarditis.