The ECG of constrictive pericarditis—Pattern resembling right ventricular hypertrophy

The ECG changes in 122 cases of constrictive pericarditis have been reviewed. Ninety-five per cent of tracings were typical and showed a normal QRS axis, low voltage, and generalized T wave flattening or inversion. The remaining six tracings showed evidence of right ventricular hypertrophy and half of these showed right axis deviation in addition. In only one could these findings be readily accounted for by the presence of severe fibrotic annular subpulmonic constriction; the remainder are unexplained and it is postulated that cardiac rotation and distortion is causative since none of the other mechanisms of right axis deviation or right ventricular hypertrophy were operative.