A Prospective Electrocardiographic and Echocardiographic Evaluation

Patients with ECG nonischemic ST segment elevation were prospectively studied to determine the accuracy of the initial ECG diagnoses. Evaluations were made of 131 consecutive patients by serial clinical, ECG, and echocardiography to establish a diagnosis. Eighty-six (66 percent) had an initial ECG interpretation of repolarization variant. Only three of the 86 (3 percent) subsequently met clinical criteria for acute pericarditis. Analysis of the mean frontal T he ECG ST-segment elevation that occurs with benign early repolarization variant may at times be indistinguishable from acute pericarditis because of similar morphologic features. When the initial ECG impression is early repolarization variant or acute pericarditis, further clinical evaluations are often required to confirm the diagnosis. Previous studies have examined in detail the ECG characteristics of acute pericarditis and repolarization variant.’-4 This prospective study was conducted to determine the clinical features of patients in whom the initial ECG interpretation was early repolarization variant or acute pericarditis. The diagnostic reliability of the initial ECG interpretation was assessed.