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Medicine General 63a0feb8

All are true about acute pericarditis except:

A
Pain radiate to left shoulder & arm
B
Widespread elevation of the ST segments, often with upward concavity & then return to baseline
C
Pain relieved by lying supine & intensified by sitting up and leaning forward
D
Coicosteroid relieves symptoms
High-Yield Explanation
Answer- C. Pain relieved by lying supine & intensified by sitting up and leaning forwardThe characteristic pain of pericarditis is retrosternal, radiates to the shoulders and neck (retrosternal, and left precoridal).Characteristically, pericaridial pain may be relieved by sitting up and leaning forward and is intensified by lying supine.A pericardial friction rub is a high-pitched superficial scratching or crunching noise, produced by movement of the inflamed pericardium.There are four stages of ECG changes in the evolution of acute pericarditis.In stage 1, there is widespread elevation of the ST segments, often with upward concavity, involving two or three standard limb leads and V2 to V6, with reciprocal depressions only in aVR and sometimes V1, as well as depression of the PR segment Usually there are no significant changes in QRS complexes.In stage 2, after several days, the ST segments return to normal, and only then, or even later, do the T waves become inveed (stage 3).Ultimately, weeks or months after the onset of acute pericarditis, the ECG returns to normal in stage 4.The pain is usually relieved by aspirin.

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