PR Depression (A guide)

PR Depression

In this brief blog, we will be discussing PR depression, pronounced PR depression, the prognostic implications of PR depression, and more information about PR depression.

What Is Pronounced PR Depression?

The pronounced PR depression in an ECG monitor is implying that there is a lesion on the arteries that can lead to a heart condition. This kind of segment is typically seen as isoelectric. 

A depression or escalation in the ECG monitor can imply that there is the sign of an acute pericarditis or atrial infection. The PR depression can indicate that the monitored heart is showing the early signs of this kind of medical condition. 

This kind of segment is typically recognized in emergency rooms in the US. The PR depression can make an indication that the person is suffering from the silent killer called acute pericarditis but this kind of condition hasn’t reached its fruition. 

The knowledge of the PR depression is very beneficial for UK emergency room staff for the diagnosis of this condition. This kind of segment only shows the subtle change in the heart that can lead to an early detection of this condition.

What Is The PR Segment In ECG?

The PR segment or PR depression in ECG is the isoelectric segment that starts from the P wave to the end of the QRS complex. The following are the main medical conditions that this segment can be found in the heart monitor:

  • Pericarditis
  • Atrial ischaemia

This segment indicates the time interval between the reticular activation to the ventricular activation. This segment also implies if the ventral arteries are behaving normally as they should be.

This segment is also considered as the monitor’s baseline. In this case, a wave or deflection can easily be found if you use this segment as a baseline. 

The electrical impulse in this condition can’t move from ventral myocardium to atrial myocardium in the heart system. You can learn more about reading PR segments in heart monitors by buying this book on this website.

Pericarditis

Pericarditis is the inflammation or swelling of the pericardium which can cause chest pain, tachycardia, and other pain that centres on the chest. There might even be an indication of pericardial diffusion in this condition. 

There is a fluctuated segment when the myocardium is involved in this disease caused by infection.  You can tell if the person has this condition if the following are observed

  • Fluctuating concave ST escalation and PR depression throughout most of the limb leads which are I, II, III, aVL, aVF and precordial leads or V2-6.
  • Reciprocal ST depression and PR escalation in lead aVR or ± V1.
  • Sinus tachycardia is also typical in the acute form of this condition caused by pain and/or pericardial effusion.

The causes of this medical condition are the following:

  • Infectious which are typically viral such as coxsackievirus, occasionally bacterial, fungal, TB
  • Immunological such as SLE or rheumatic fever
  • Uraemia
  • Post-myocardial infarction or Dressler’s syndrome
  • Trauma
  • After cardiac surgery such as for postpericardiotomy syndrome
  • Paraneoplastic syndromes
  • Drug-induced such as isoniazid or cyclosporin
  • Post-radiotherapy

Benign Early Repolarisation can be hard to distinguish between this medical condition due to both complications having a concave ST escalation. 

A trick that some doctors used is to check out the T wave that goes through the segment. ST-elevation promodial myocardium is hard to distinguish between the ST segment escalation of pericarditis.

Symptoms Of Pericarditis

The symptoms of this condition are the following:

  • chest ache or pain that feels like a stabbing sensation
  • pain in the neck that may spread across the shoulders and/or arms
  • a fever
  • nausea or feeling like you want to vomit
  • feeling light-headed
  • unexpected shortness of breath if you experience this symptom, you need to get immediate medical intervention.

The chest pain can get worse if you try to lean too much on your front or try to lay on your back when you’re sleeping. 

As one of its symptoms, you might feel like someone is pushing hard on your chest that can leave you breathless. Some affected patients will even get highly distressed since they keep vomiting which can hurt their throats a lot.

ECG is one of the tests that you will be talking if you are assessed to have this complication. This can help you to get the medical intervention you need before you get too distressed. 

You should find the benefits of our advanced technologies. This can improve your health in the early periods before it gets worse.

Atrial Ischaemia

Atrial ischaemia is a medical condition that is described to have a constriction of the arterial walls that can lead to minimal blood flow to the arteries. If you can recall, this condition can also be implied in the PR segment the same as pericarditis. 

Atrial fibrillation has been said to be an outcome of this condition but studies are still not sure about this correlation. This condition can cause the fluctuation of sinus rhythm which can lead to ventricular injury in the walls of the heart which can make a dysfunction in blood flow. 

You can learn more about this kind of condition by buying this book on this website.

PR Depression (A guide)

PQ or ST Segment Elevated

An ST elevation is when the line shown in the heart monitor is the ST segment being beyond the baseline of the segment. This segment begins from the J point in which the end of the QRS complex and the start of ST-segment and completes with the T wave. 

The myocardial cells that is interpreted by this segment have gone through a phase from depolarisation or repolarisation. There is no difference between the muscle cells when this segment is labelled normal. 

The distortion in the line of this segment can imply an elevation or decrease that can imply an abnormal state in the heart. For instance, the occurrence of having an elevation in the mV in 0.04 seconds can imply a primordial fluctuation in some arteries.

The baseline is either the PR interval or the TR interval. This baseline can give you a false positive rate in 15 to 20 per cent of the time and a false negative in 20 to 30 per cent of the time. 

The weakening of the cardiac activity can lead to a weak H wave in the ECG or heart monitor.

PR Depression For Differential Diagnosis

The deviation in the PR segment has not been taken note of in studies on the detection of some cardiac signs of disease in affected people. For instance, myopericarditis is not easily detected by the elevation of this segment which can lead to late treatment and the worsening of the condition in the midst of this treatment. 

There are others who have combined this kind of segment in the limbs which can lead to the prediction of this disorder. This kind of segment has also been helpful in differentiating patient with myopericarditis and STEMI. 

This kind of information should be added in diagnosis evaluations of these conditions to help predict the ST elevation better. This can lead to giving the patient to right treatment depending on the presenting symptoms. 

You can learn more about this STEMI condition by buying this book on this website.

PR Depression (A guide)

Early Diagnostic Feature For Acute Pericarditis

The knowledge of this segment that can help diagnose pericarditis is still not acknowledged by UK A & E specialists. This can lead to the late intervention of this condition through therapy that is prescribed for this condition. 

To diagnose this condition, one needs to undergo the following tests: 

  •  chest pain
  • pericardial friction-rub
  • characteristic ECG changes such as new fluctuated ST-elevation or PR depression 
  • pericardial effusion

There is also the checking of the patient’s protein levels and white blood cells to help confirm this condition. 

Association Between PR Segment Depression And Asymptomatic Pericardial Effusion

Pericardial effusion is not the most typically researched condition used in ECG. Echocardiography is what doctors used to find out if the patient has this kind of condition. 

This kind of condition seen in echocardiography may reveal fluid retention which isn’t seen in ECG that may conclude with a pericardial injury. As mentioned before, a certain segment can bring up the conclusion of pericarditis in the patient. 

This kind of segment has been only monitored in the ECG if the acute pericardial injury has come to past. This kind of segment is almost a typical sign of inflammatory involvement in the cardial tombs that tends to be silent in patients. 

You can learn more about pericardial effusion and how it affects a patient by buying this book on this website.

PR Depression (A guide)

Interpreting A PR Segment

As mentioned before, the PR segment is a portion that begins from the P wave to the QRS complex. This segment can be measure through lapses in time which is different from the PR interval which is your baseline. You need to remember that segments are different than intervals. 

You can analyze these segments by checking their movement on the isoelectric line that can move to elevation or a decrease which means the monitor has detected an abnormality.

You should take note that abnormalities in these segments are not typical which makes it more important for you to detect anything in particular such as the slight elevation that had only lasted for a few seconds. 

You can learn more about interpreting these segments and getting the patient the help he or she needs by buying this book on this website. 

Conclusion

In this brief blog, we will be discussing PR depression, pronounced PR depression, the prognostic implications of PR depression, and more information about PR depression.

If you have any questions about PR depression, please let us know and the team will gladly answer your questions.

FAQs: pr depression

What does pericarditis look like in ECG?

Pericarditis looks like there’s a split concave-upward ST-segment elevation, ST-segment depression in aVR and PR-segment depression in ECG is best monitored in leads II and V3 in this kind of heart monitor technology. You also need to note that the ST/T ratio is greater than 0.25 which is a finding frequently indicative of acute pericarditis which is a chronic medical condition.

What is the normal PR interval on ECG?

The normal PR interval on ECG is the interval between 120 – 200 ms or 0.12-0.20s in duration which is three to five small squares in this kind of heart monitor technology. If the PR interval is greater than 200 ms, the first- degree heart block is said to be apparent in this monitoring technology.

Is a short PR interval normal?

No, a short PR interval is not normal in terms of reading waves in an ECG. This is because these kinds of signals that the patient may have clinical tachycardia which can only be detected by a lower degree from the normal PR interval amount.

What causes short PR interval?

The causes of a short PR interval are an atrioventricular reentrant tachycardia which can be elicited due to Wolff–Parkinson–White syndrome or Lown–Ganong–Levine syndrome or junctional rhythm or a heart block. This kind of condition should be treated immediately.

Is pericarditis painful?

Yes, pericarditis is painful. This is because you will feel a constant stabbing on the chest with this kind of condition. You may also feel nauseated due to this kind of medical complication. If you lie down or take a deep breath, you’re only increasing the pain of this complication.

Citations

BMJ Journals. Pronounced PR depression.

Cardiocases. PQ-segment elevation and depression.

ECG & ECHO LEARNING. The PR Interval & PR Segment.

EUSEM. P-R segment depression: an early diagnostic feature in acute pericarditis: a telephone survey of UK accident and emergency departments.

Healio. PR Segment.

LITFL. Pericarditis.

LITFL. PR segment.

NCBI. PR depression is useful in the differential diagnosis of myopericarditis and ST elevation myocardial infarction.

ScienceDirect. clinical correlates of pr-segment depression in asymptomatic patients with pericardial effusion.

PR Depression (A guide)

Juanita Agboola

Juanita Agboola is the editor in chief of HFNE and an expert in mental health online. She has been writing about online behaviour, mental health and psychology issues since 2012. All Guides are reviewed by our editorial team which constitutes various clinical psychologists, PhD and PsyD colleagues.