Thursday, 28 July 2016

Spodick's sign: Downsloping TP segment in pericarditis

There are lots of eponymous signs in ECG interpretation (Wellens, Mobitz, Wenckebach and so on), so it's always interesting to discover a new one. That's what happened to me this week when I stumbled across Spodick's sign, which is used in the ECG diagnosis of pericarditis.

Spodick's sign refers to concave JT-segment elevation followed by a slight downsloping of the TP-segment. This slight downsloping in highlighted by the red arrows in the figure below, which shows ECG lead II in a patient with acute pericarditis.

Spodick's sign: Downsloping of the TP segment

Spodick's sign is reported to be present in around 80% of cases of acute pericarditis, although the reliability of the sign as a diagnostic indicator has been questioned by some.

Spodick's sign is named for David H. Spodick, who is Professor of Medicine Emeritus at the University of Massachusetts Medical School. You can read some of his publications on the ECG pericarditis here and here.

Have you spotted Spodick's sign on an ECG in pericarditis? Have you found it diagnostically helpful? Why not post a comment below?

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