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Recognized electrocardiographic abnormalities associated with pericardial disease include ventricular repolarization phenomena and simultaneous electrical alternans of the P wave and QRS complex. Atrial ST segment changes (S-Ta segment) have also been described in pericardial disease but not recently emphasized. Five patients had S-Ta segment changes (two with uremic pericarditis, two with hemorrhagic pericarditis caused by ruptured aneurysms, and one with idiopathic pericarditis). Four patients had S-Ta segment change resolution concomitant with clinical improvement; the remaining patient died prior to pericarditis resolution. The electrocardiographic findings in each case demonstrated elevation of S-Ta segments in aVR and depressions in other leads in addition to ventricular repolarization abnormalities. Atrial injury currents occur in pericarditis in the absence of other known causes of atrial injury. The incidence of this electrocardiographic finding in pericarditis is unknown but is apparently common.

Transvenous cardiac pacing is now routinely used as therapy for heart block. As experience with transvenous pacing has increased, it has become apparent that a significant cause of pacemaker failure has resulted from malposition of the electrode catheter in the coronary veins. A simple technique ensures proper placement of the electrode catheter in the right ventricle by utilizing the intracavitary electrocardiogram.

ALTHOUGH it is well known that infective endocarditis occurs on previously diseased heart valves, we were unable to find any reports in the English-language literature of infective endocarditis occurring subsequent to traumatically induced aortic regurgitation. We report a probable case of this entity, which we believe is an important one to consider, since proper modern-day antibiotic prophylaxis or treatment has changed the course of infective endocarditis.Report of a CaseA 56-year-old man was admitted on Feb 4, 1973, with complaints of inability to sleep, increasing shortness of breath for two weeks, and inability to move the left side of his body since the previous evening. Several weeks before admission, he had been treated at another hospital for congestive heart failure with digitalis and diuretics, but continued to have shortness of breath and occasional epigastric and chest pains after discharge. He was in good health until December 1967, when he