Rossello et al identified a number of changes in the electrocardiogram (ECG) that can help to differentiate acute pericarditis from acute myocardial infarction. The authors are from multiple institutions in Spain.
Parameters:
(1) QRS duration in leads with ST-segment elevation
(2) QT dispersion
(3) PR deviation in lead aVR
(4) J point level in lead aVR
(5) number of leads with ST-segment elevation
(6) number of leads with ST-segment depression
(7) number of leads with PR-segment depression
Parameters
Findings
Points
QRS duration with ST elevation
<= 70 ms
1
> 70 ms
0
QT dispersion
<= 63 ms
1
> 63 ms
0
PR deviation in aVR
>= 0 mV
1
< 0 mV
0
J point level in aVR
<= -0.5 mV
1
> -0.5 mV
-
leads with ST segment elevation
>= 7
1
< 7
0
leads with ST segment depression
0 or 1
1
>= 2
0
leads with PR segment depression
0
0
>= 1
1
where:
• The paper reports >= 0 leads with PR segment depression predictive of pericarditis, but >= 1 seems more likely.
number of findings seen with acute pericarditis =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 7
Performance:
• The model has a sensitivity of 86% and specificity of 83%.
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