July/2006
There is no evidence of left anterior fascicular block because the electrical forces for the QRS complex in lead II are NOT negative. There is no evidence of right axis deviation because the QRS forces in lead I are not negative. There is no evidence of ST elevation in leads II, III and avF or II and III, or II and avF or III or avF (the various combinations of the 3 inferior leads). Remember that the baseline from which you need to evaluate ST elevation is the T-P interval. Electrocardiographic abnormalities for acute pericarditis may vary. However, one common denominator is the ST segment in lead avR, the cavity lead, the one “reporting” the negative, average of the electrical signals of the other 5 limb leads. If there is pericarditis, the ST segment in lead avR should be either elevated or depressed but NOT isoelectric. There is indeed an abnormal R wave progression in the chest leads. Most references and cardiology authorities associated this abnormality in more than 80% of cases with ischemic heart disease.
