Pericarditis and ECG Clues

Pericarditis inflames the sac around the heart and often irritates the superficial myocardium immediately beneath it. That anatomy creates a recognizable combination: sharp, breathing-related chest pain that improves when the patient sits forward, together with widespread rather than territorial ECG changes. The pattern is useful, but it is not a permission slip to dismiss acute coronary syndrome. An experienced nurse notices the patient's position, work of breathing, blood pressure, jugular venous pressure, and mental status while obtaining a 12-lead ECG. The immediate questions are whether the pain could represent coronary occlusion and whether an effusion is beginning to restrict cardiac filling.