What ECG findings are typical of acute pericarditis?

What ECG findings are typical of acute pericarditis?

• A. ST segment elevation in limited leads
• B. T-wave inversion
• C. No changes
• D. Diffuse ST segment elevation and PR depression

Answer: (D)

Acute pericarditis causes inflammation that affects the heart’s electrical activity in a diffuse way, so the ECG changes are broad rather than localized. The hallmark is diffuse ST-segment elevation that is usually concave upward, seen across many leads, along with PR-segment depression in those same leads (and often PR elevation in aVR). This combination distinguishes pericarditis from a myocardial infarction, which tends to produce ST elevations confined to a specific coronary territory and lacks the widespread PR depression. As the inflammation resolves, ST elevations normalize and T-wave inversions may appear in some leads. The other patterns—T-wave inversion alone, no changes, or ST elevation limited to a few leads—do not reflect the typical widespread inflammatory process of acute pericarditis.

Acute pericarditis causes inflammation that affects the heart’s electrical activity in a diffuse way, so the ECG changes are broad rather than localized. The hallmark is diffuse ST-segment elevation that is usually concave upward, seen across many leads, along with PR-segment depression in those same leads (and often PR elevation in aVR). This combination distinguishes pericarditis from a myocardial infarction, which tends to produce ST elevations confined to a specific coronary territory and lacks the widespread PR depression. As the inflammation resolves, ST elevations normalize and T-wave inversions may appear in some leads. The other patterns—T-wave inversion alone, no changes, or ST elevation limited to a few leads—do not reflect the typical widespread inflammatory process of acute pericarditis.