Open AccessPR depression with multilead ST elevation and ST depression in aVR by left circumflex artery occlusion: How to differentiate from acute pericarditis
Author(s) -
Zhan ZhongQun,
Nikus Kjell,
Birnbaum Yochai
Publication year - 2020
Publication title -
annals of noninvasive electrocardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.494
H-Index - 48
eISSN - 1542-474X
pISSN - 1082-720X
DOI - 10.1111/anec.12752
Subject(s) - medicine , acute pericarditis , pericarditis , st segment , cardiology , st elevation , myocardial infarction , chest pain , qrs complex , electrocardiography , depression (economics) , st depression , circumflex , benign early repolarization , occlusion , qt interval , elevation (ballistics) , artery , geometry , mathematics , economics , macroeconomics
PR‐segment depression with multilead ST‐segment elevation and ST‐segment depression in lead aVR are classic ECG manifestation of acute pericarditis. We present a patient, where the etiology of these ECG features was acute ST‐elevation myocardial infarction due to left circumflex artery occlusion. To avoid misdiagnosis, unnecessary examinations, and inappropriate therapeutic decisions, the possibility of ST‐segment elevation myocardial infarction should be kept in mind even when ECG changes typical for pericarditis are encountered in chest pain patients. Findings of QRS widening and QT interval shortening in leads with ST‐segment elevation could help to differentiate acute ST‐segment elevation myocardial infarction from acute pericarditis.