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Patient
61-year-old man with influenza-like illness 15 days earlier; hospitalization for chest pain;
Trace
Sinus rhythm, diffuse PQ segment depression (maximum in leads I, II and inferior leads) with PQ elevation in aVR and V1, moderate lateral ST-segment elevation; possible alternating amplitude of the QRS visible in V1 and V2;
A cardiac ultrasound revealed a moderate pericardial effusion. The association between chest pain (increased by inspiration and lessened by leaning forward), the electrocardiogram (diffuse PQ segment depression), pericardial effusion and a biological inflammatory syndrome leads to the diagnosis of acute pericarditis. A few minutes after the first tracing, palpitations and recording of this second tracing;
Trace
Atrial extrasystole bursts followed by initiation of an episode of atrial fibrillation (irregular tachycardia with narrow QRS with baseline tremor);
Trace
Atrial fibrillation;
Trace
Tracing recorded 3 days later; asymptomatic patient with normalization of the electrocardiogram;
Exergue
Acute pericarditis is one of the recognized etiologies of atrial arrhythmia. It appears, however, that inflammation of the atrial pericardium can only be considered as a cofactor in the initiation of atrial arrhythmia in patients previously at risk.
This patient presented an acute pericarditis complicated by an episode of spontaneously resolving atrial fibrillation. The literature describes a number of cases of paroxysmal or persistent atrial arrhythmias occurring in a setting of acute or chronic pericarditis.