What might indicate the presence of acute pericarditis on an ECG?

What might indicate the presence of acute pericarditis on an ECG?

• A. ST elevation in multiple leads without Q waves
• B. Deep T wave inversions in V1-V3
• C. Wide QRS complexes
• D. Prolonged PR interval

Answer: (A)

The presence of acute pericarditis on an ECG is most commonly indicated by ST elevation in multiple leads without the presence of Q waves. This characteristic pattern results from inflammation of the pericardium, which can affect the myocardial surface layers leading to diffuse ST segment elevation. In acute pericarditis, the ST elevation is typically concave in nature and occurs in most precordial and limb leads, reflecting the widespread involvement of the myocardium. The lack of corresponding Q waves distinguishes this finding from ST elevation seen in myocardial infarction, where the development of Q waves is indicative of myocardial necrosis. The other choices do not correlate with the classic findings of acute pericarditis. Deep T wave inversions in specific leads are more typically associated with conditions like ischemia or previous myocardial infarction. Wide QRS complexes may suggest a bundle branch block or other conduction disturbances rather than pericarditis. A prolonged PR interval can indicate atrioventricular block, which is also not a primary feature of acute pericarditis. Thus, the presence of widespread ST elevation without Q waves serves as a hallmark of acute pericarditis on the ECG.

The presence of acute pericarditis on an ECG is most commonly indicated by ST elevation in multiple leads without the presence of Q waves. This characteristic pattern results from inflammation of the pericardium, which can affect the myocardial surface layers leading to diffuse ST segment elevation.

In acute pericarditis, the ST elevation is typically concave in nature and occurs in most precordial and limb leads, reflecting the widespread involvement of the myocardium. The lack of corresponding Q waves distinguishes this finding from ST elevation seen in myocardial infarction, where the development of Q waves is indicative of myocardial necrosis.

The other choices do not correlate with the classic findings of acute pericarditis. Deep T wave inversions in specific leads are more typically associated with conditions like ischemia or previous myocardial infarction. Wide QRS complexes may suggest a bundle branch block or other conduction disturbances rather than pericarditis. A prolonged PR interval can indicate atrioventricular block, which is also not a primary feature of acute pericarditis. Thus, the presence of widespread ST elevation without Q waves serves as a hallmark of acute pericarditis on the ECG.