Purpose To determine the findings on right-sided precordial electrocardiograms in patients with pericarditis following cardiac surgery.
Method During a one year period 72 subjects with pericardial friction rubs following heart surgery were identified. These 72 represented 11 percent of the total number of adult patients who had pericardial incisions at surgery. The friction rubs were ascertained by daily examination. When a rub was detected, a twelve lead electrocardiogram was obtained prospectively in the standard position and with right-sided precordial leads.
Results Of these 72 subjects, 29 (40.3%) had non-diagnostic findings for pericarditis on the standard electrocardiogram. Twenty of twenty-nine patients (69%) in the latter group had ST segment depression, T-wave inversion or a myocardial infarct pattern on right-sided leads whereas six of twenty-nine patients (21%) had concave ST segment elevation suggestive of pericarditis. Two subjects had right-sided ST segment elevation and T-wave inversion. One patient had isolated right-sided lead low QRS voltage.
Conclusion In subjects with post-operative pericardial friction rubs following cardiac surgery a significant number (28%) with non-diagnostic standard electrocardiograms have findings suggestive of pericarditis on right-sided precordial leads.