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STEMI vs pericarditis

DimensionSTEMIPericarditis
ST elevation shapeConvex or straight, territorialConcave, diffuse across territories
Reciprocal depressionPresent, and confirmatoryAbsent (except aVR and V1)
PR segmentUsually neutralDepressed, elevated in aVR
PainPressure, exertional coloringSharp, pleuritic, positional (better leaning forward)
Stakes of the errorMissed reperfusionThrombolytics given to a pericardium: hemorrhage risk

Pearls

  • Reciprocal changes are the single most useful discriminator.
  • Age, risk factors, and the pain's character vote alongside the tracing.

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