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Related Concept Videos

Pericarditis II: Clinical Features and Diagnostic Tests01:19

Pericarditis II: Clinical Features and Diagnostic Tests

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Pericarditis is distinguished by inflammation of the pericardium, the fibrous sac that encases the heart. It can be acute, lasting less than six weeks, or chronic, persisting for over three months. Understanding its clinical manifestations and diagnostic findings is crucial for timely and effective management.Clinical ManifestationsWhile pericarditis can be asymptomatic, it usually presents with characteristic symptoms such as:Chest Pain: The most characteristic symptom of pericarditis is chest...
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Pericarditis I: Introduction01:22

Pericarditis I: Introduction

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Pericarditis is defined as the inflammation of the pericardium, the thin, sac-like membrane surrounding the heart. This condition can cause significant chest pain and other symptoms, often necessitating medical intervention. The pericardium has two layers: the inner visceral layer and the outer parietal layer, separated by a small amount of fluid that reduces friction during heartbeats.Types of PericarditisPericarditis can be classified into several types based on the duration and nature of the...
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Pericarditis III: Medical Management01:17

Pericarditis III: Medical Management

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The primary objectives of managing pericarditis are to determine the underlying cause, provide effective therapy for treatment and symptom relief, and promptly detect signs and symptoms of cardiac tamponade. The following outlines the essential aspects of medical management for pericarditis:ObjectivesDetermine the Cause: Identifying the underlying cause of pericarditis is crucial for targeted treatment. Causes include viral infections, autoimmune diseases, post-cardiac injury syndrome, and...
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Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

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Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
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Myocarditis I: Introduction01:21

Myocarditis I: Introduction

160
Myocarditis is inflammation of the myocardium, which is the muscular layer of the heart.EtiologyMyocarditis has a diverse etiology, including a wide range of infectious and non-infectious causes:Infectious CausesViral: Common viruses include Coxsackie A and B, adenovirus, parvovirus B19, enteroviruses, and influenza A.Bacterial: Examples include infections caused by Streptococcus, Staphylococcus, and Mycoplasma species.Rickettsial: Infections like Rocky Mountain spotted fever can result in...
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Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

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Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
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Related Experiment Video

Updated: Nov 19, 2025

An Intact Pericardium Ischemic Rodent Model
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Persistent PR segment change in malignant pericardial disease.

M Ahluwalia1, R O'Quinn2, B Ky2

  • 1Department of Medicine, University of Pennsylvania Perelman School of Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, 100 Centrex, Philadelphia, PA, 19104, USA. monica.ahluwalia@uphs.upenn.edu.

Cardio-Oncology (London, England)
|February 3, 2021
PubMed
Summary
This summary is machine-generated.

PR segment changes on ECGs are highly indicative of malignant pericardial disease in cancer patients with pericardial effusions. Their presence predicts malignancy with 100% accuracy, offering significant diagnostic value.

Keywords:
PR depressionPR elevationPR segmentmalignant pericardial disease

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Area of Science:

  • Cardiology
  • Oncology
  • Diagnostic Electrocardiography

Background:

  • Electrocardiographic (ECG) changes, including PR segment alterations, can occur in patients with pericardial effusions.
  • PR segment changes are often overlooked but may hold diagnostic significance.
  • The utility of PR segment changes in differentiating benign from malignant pericardial disease in cancer patients remains under-investigated.

Purpose of the Study:

  • To investigate the relationship between PR segment changes on ECGs and the presence of malignant pericardial disease.
  • To assess the diagnostic value of PR segment changes in cancer patients with pericardial effusions.

Main Methods:

  • Retrospective review of 104 pre- and post-operative ECGs from 26 cancer patients with pericardial effusion undergoing pericardial window surgery.
  • Definition of PR segment changes as a deviation of at least 0.5 millivolts from the TP segment.
  • Evaluation of pericardial fluid cytology, flow cytometry, and tissue biopsy for malignancy confirmation.

Main Results:

  • Eight out of 26 patients (31%) exhibited significant PR segment changes (depression in inferior leads, elevation in aVR/V1).
  • All 8 patients with PR segment changes had pathologically confirmed malignant pericardial disease, yielding a 100% positive predictive value.
  • Eighteen patients (69%) had isoelectric PR segments, with none showing evidence of malignant pericardial disease (100% negative predictive value).
  • PR segment changes persisted on serial ECGs for up to 11 months post-operatively.

Conclusions:

  • The presence of PR segment changes on ECGs is a strong predictor of malignant pericardial disease in cancer patients with pericardial effusions.
  • PR segment changes demonstrate high diagnostic accuracy for malignant pericardial disease in this population.
  • These ECG findings can persist long-term, aiding in the diagnosis and management of cancer-related pericardial disease.