Why the study?
ECG features typical for acute pericarditis can lead to misdiagnosis and inappropriate management when the underlying cause is ST-elevation myocardial infarction.
QRS widening and QT interval shortening in leads with ST elevation can help distinguish STEMI from acute pericarditis in patients with classic pericarditis-like ECG changes.
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Pericarditis-like ECG may reflect circumflex STEMI; cautions misdiagnosis and leaves open ECG specificity.
PR-segment depression with multilead ST-segment elevation and ST-segment depression in lead aVR are classic ECG manifestation of acute pericarditis. We present a patient, where the etiology of these ECG features was acute ST-elevation myocardial infarction due to left circumflex artery occlusion. To avoid misdiagnosis, unnecessary examinations, and inappropriate therapeutic decisions, the possibility of ST-segment elevation myocardial infarction should be kept in mind even when ECG changes typical for pericarditis are encountered in chest pain patients. Findings of QRS widening and QT interval shortening in leads with ST-segment elevation could help to differentiate acute ST-segment elevation myocardial infarction from acute pericarditis.
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Zhan et al. (2020) studied this question.
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