MI 與 pericarditis 區分

Unlike pain from myocardial ischemia, chest pain due to pericarditis is most often sharp and pleuritic in nature, with exacerbation by inspiration or coughing. One of the most distinctive features is the tendency for a decrease in intensity when the patient sits up and leans forward.

This position (seated, leaning forward) tends to reduce pressure on the parietal pericardium, particularly with inspiration, and may also allow for splinting of the diaphragm.

Radiation of chest pain to the trapezius ridge has also been considered to be fairly specific for pericardi...

CHEST PAIN

MI 與 pericarditis 區分

Unlike pain from myocardial ischemia, chest pain due to pericarditis is most often sharp and pleuritic in nature, with exacerbation by inspiration or coughing. One of the most distinctive features is the tendency for a decrease in intensity when the patient sits up and leans forward.

This position (seated, leaning forward) tends to reduce pressure on the parietal pericardium, particularly with inspiration, and may also allow for splinting of the diaphragm.

Radiation of chest pain to the trapezius ridge has also been considered to be fairly specific for pericarditis. 

Pericardial friction rub

The presence of a pericardial friction rub on physical examination is highly specific for acute pericarditis.

Electrocardiogram

In the first hours to days,  diffuse ST elevation (typically concave up) with reciprocal ST depression in leads aVR and V1.

PR interval：代表心房開始去極化（P波）至心室開始去極化（QRS複合波）的時間，也是AV node 傳導的一個重要指標

ST segment:
a. usually isoelectric（等電位，在圖上平平的）
b. 在V1~V3可能升高至2mm（青少年常見），其它導極也可能升高至1mm
c. ST segment臨床上常見於心肌損傷

PR interval：代表心房開始去極化（P波）至心室開始去極化（QRS複合波）的時間，也是AV node 傳導的一個重要指標

ST segment:
a. usually isoelectric（等電位，在圖上平平的）
b. 在V1~V3可能升高至2mm（青少年常見），其它導極也可能升高至1mm
c. ST segment臨床上常見於心肌損傷