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ECG library

Acute pericarditis

advanced

A 28-year-old with sharp chest pain that eases when leaning forward, one week after a viral illness.

25 mm/s · 10 mm/mV · synthetic tracing
100%
IIIIIIaVRaVLaVFV1V2V3V4V5V6
II (rhythm)
Calipers:2000 ms50.0 small boxes30 bpm if R-RDrag the orange markers. One small box = 40 ms.

Key findings

  • Diffuse concave STE
  • PR depression
  • No reciprocal changes
  • No territorial pattern

Learning points

  • STEMI respects coronary territories; pericarditis ignores them.
  • PR depression is the most specific everyday clue.
  • The stakes of the distinction: thrombolysing pericarditis can cause tamponade.

Connected