Diagnosing acute pericarditis can be challenging, especially when it comes to interpreting subtle signs on the electrocardiogram (ECG). Among the various electrocardiographic findings, Spodick's sign stands out as an important, although often underestimated, indicator. In this post, we explore what Spodick's sign is, how to identify it, and why it is relevant in the setting of acute pericarditis.
What Is Spodick's Sign?
Spodick's sign refers to a downsloping TP segment on the ECG, creating the impression of a “slope” in the baseline. This sign, described by Dr. David Spodick in 1974, is especially visible in lead II and in the lateral precordial leads. In patients with acute pericarditis, Spodick's sign can be found in about 29% of cases and is one of the most specific signs of the condition.
Clinical Importance and a Retrospective Study
A recent retrospective study analyzed patients with myocardial infarction and pericarditis and found that Spodick's sign was seen in 5% of patients with infarction and in 29% of patients with pericarditis. This finding highlights the usefulness of the sign but also underscores the need for further studies to validate these results and improve differential diagnosis.
Learn More
For a more detailed review of acute pericarditis and its diagnostic criteria, visit our ECG Library.
References
- Spodick DH. Electrocardiogram in acute pericarditis. Distributions of morphologic and axial changes by stages. Am J Cardiol. 1974;33(4):470–4.
- Witting MD, Hu KM, Westreich AA, Tewelde S, Farzad A, Mattu A: Evaluation of Spodick’s sign and other electrocardiographic findings as indicators of STEMI and pericarditis. J Emerg Med. 2020, 58:562-569.
