What is the characteristic EKG finding in acute pericarditis?

What is the characteristic EKG finding in acute pericarditis?

• A. ST elevations limited to inferior leads
• B. Diffuse ST elevation with PR depression
• C. ST depression
• D. Normal ECG

Answer: (B)

In acute pericarditis, the inflammation of the pericardium creates a diffuse, global injury current that causes widespread ST-segment elevation across multiple leads. This ST elevation is usually concave upward and is accompanied by PR-segment depression, a pattern commonly seen in several leads with PR elevation in aVR. This combination—diffuse, nonterritorial ST elevations with PR depressions—is what sets acute pericarditis apart from other causes of chest pain, especially myocardial infarction, where ST elevations are localized to a specific coronary territory and often accompanied by reciprocal ST depression in opposite leads and a different contour. A normal ECG or isolated ST depression would not fit the classic acute pericarditis pattern.

In acute pericarditis, the inflammation of the pericardium creates a diffuse, global injury current that causes widespread ST-segment elevation across multiple leads. This ST elevation is usually concave upward and is accompanied by PR-segment depression, a pattern commonly seen in several leads with PR elevation in aVR. This combination—diffuse, nonterritorial ST elevations with PR depressions—is what sets acute pericarditis apart from other causes of chest pain, especially myocardial infarction, where ST elevations are localized to a specific coronary territory and often accompanied by reciprocal ST depression in opposite leads and a different contour. A normal ECG or isolated ST depression would not fit the classic acute pericarditis pattern.