Dolor torácico no coronario. Papel del electrocardiograma en el diagnóstico diferencial de la pericarditis aguda y la repolarización precoz

Introduction and objectives

Electrocardiogram plays a fundamental role in the differential diagnosis of chest pain. It is sometimes difficult to differentiate these 2 entities: acute pericarditis and early repolarization. The aim of this study was to establish electrocardiographic characteristic to allow their differentiation.

Method

We included retrospectively a sample of patients who were hospitalized due to a non ischemic chest pain who showed ST segment elevation on the electrocardiogram between January 2010-December 2015. The patients were classified according to the electrocardiographic evolution and presence/absence of other pericarditis criteria in 2 groups: acute pericarditis and chest pain with a pattern of early repolarization.

Results

The study included 93 patients (76 patients with acute pericarditis and 17 patients with early repolarization) and they had a mean age of 35 ± 15 years, whom 80% were male. The patients with acute pericarditis showed higher ST segment elevation and a bigger ST/T ratio in V5 and V6, being the result statistically significant (P < .001). ST/T ratio in V5 with a cut-off point of 0.19 appears to be the most discriminative parameter in a significant way.

Conclusions

ST segment elevation and fundamentally ST/T ratio in V5 and V6 are useful for the differential diagnostic between acute pericarditis and early repolarization.