Key result
Widespread ST elevation with midsegment sagging and PR deviations confirms acute pericarditis.
Why the study?
Differentiating causes of chest pain with widespread ST segment elevation on ECG in young patients is clinically challenging and requires careful interpretation.
Case Report (n=1)
Widespread ST segment elevation combined with PR segment depression in lead II and elevation in aVR are strong confirmatory ECG signs of acute pericarditis.
This case presentation suggests a number of possible diagnoses: myocardial ischemia / infarction, pulmonary embolism, pericarditis, even non-specifi c cardiac pain associated with tachycardias and also noncardiac pain.This ECG is diagnostic.Could the ECG be in keeping with myocardial ischemia as in an acute coronary syndrome presentation requiring heparin or myocardial infarction of the ST segment elevation type requiring a thrombolytic or PCI in the cath lab?Certainly, there is ST segment elevation.However:The elevation is widespread, occurring in 5 of the 6 chest leads and in 4 of the limb leads, also with ST segment depression in aVR.Thus, there are only 2 leads with iso-electric STs.If due to myocardial ischemia, it would suggest extensive involvement affecting multiple arterial territories.This would be rather unusual in a young man
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Okreglicki, Anthony (2017) conducted a case report in Acute pericarditis (n=1). The patient's ECG demonstrated widespread ST segment elevation with midsegment sagging and PR segment deviations, confirming a diagnosis of acute pericarditis.
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