Acute Pericarditis Medical Slides

Show four ECG stages sequentially: Stage 1 (diffuse concave ST elevation with PR depression, Spodick sign), Stage 2 (ST normalization, T-wave flattening), Stage 3 (diffuse T-wave inversions), Stage 4 (ECG normalization). Emphasize the key STEMI differentiators: diffuse rather than territorial ST elevation, PR depression (especially in lead II and aVR), absence of reciprocal changes, and ST/T ratio >0.25 in lead V6.

Reference COPE (2005) showing colchicine added to ASA reduced recurrence from 32.3% to 10.7% in first episodes, and CORP (2011) confirming similar benefit for recurrent pericarditis. Present dosing: 0.5 mg BID (or 0.5 mg daily if <70 kg) for 3 months in first episode, 6 months for recurrence. Note the RHAPSODY trial establishing rilonacept (IL-1 trap) for colchicine-resistant recurrent pericarditis.

Define myopericarditis as pericarditis with troponin elevation but preserved LV function (vs perimyocarditis with LV dysfunction). Emphasize that cardiac MRI showing late gadolinium enhancement in a subepicardial pattern confirms myocardial involvement. Teaching point: exercise restriction for 3-6 months per the 2015 ESC guidelines, which is critical for young athletes presenting with chest pain.