Enlargement of the heart can cause signs of localized elevation of the precordial region. It is commonly seen in pericarditis. Pericarditis is an acute inflammatory reaction and exudate of the pericardium due to bacterial, viral, autoimmune, physical, chemical and other factors, as well as chronic lesions such as pericardial adhesions, thickening, constriction, and calcification. Clinically, there are mainly acute pericarditis and chronic constrictive pericarditis. Patients have symptoms such as fever, night sweats, cough, sore throat or vomiting and diarrhea. So how to check to find out if you have precordial bulge? 1, ECG The evolution of the ECG in acute pericarditis can typically be divided into four stages: (1) ST segment is bow-back downward elevation and T wave is high. The ST/T ratio of V6 is ≥0.25. (2) After a few days, the ST segment returns to baseline and the T wave decreases and flattens. (3) T waves are symmetrically inverted and reach maximum depth without opposite changes in the corresponding leads (except for aVR and V1 upright). It may persist for weeks, months or for a long time. (4) The T wave returns to uprightness, usually within 3 months. There may be an atypical evolution of the lesion when it is mild or limited, with changes in the ST segment and T wave in some leads and changes in the ST segment or T wave only. 2. Echocardiography examines the presence of pericardial effusion and helps to confirm the diagnosis of acute pericarditis. The amount of pericardial effusion can be estimated, indicating the presence of cardiac compression and whether it is combined with other cardiac diseases, such as myocardial infarction and heart failure. The features of cardiac tamponade are: diastolic collapse of the right atrium and right ventricle; increase in right ventricular internal diameter during inspiration, decrease in left ventricular internal diameter, leftward shift of the septum, etc. 3. Blood tests in infected patients may show increased white blood cell count, increased erythrocyte sedimentation rate and increased C-reactive protein concentration. Troponin may be mildly elevated, possibly related to inflammatory stimulation of the epicardial myocardium. Most patients with acute pericarditis with elevated troponin have normal coronary angiograms. 4.X-ray examination shows that the heart shadow is enlarged to both sides and the heart beat is weakened; especially the lung is not obviously congested but the heart shadow is obviously enlarged is strong evidence of pericardial effusion, which can be distinguished from heart failure. In adults with fluid volume less than 250 ml, it is difficult to detect pericardial effusion by X-ray. 5. Cardiac CT or cardiac MRI Cardiac CT and cardiac MRI are increasingly used to diagnose pericarditis, and both are very sensitive in detecting pericardial effusion and measuring the thickness of the pericardium. Cardiac CT can measure the thickening of the pericardium in acute pericarditis, but it is not an indicator for the diagnosis of acute pericarditis. The most sensitive method of diagnosing acute pericarditis is delayed imaging with pericardial MRI.