What ECG finding is characteristic of acute pericarditis?

What ECG finding is characteristic of acute pericarditis?

• A. ST depression in V1-V4
• B. No ECG changes
• C. Diffuse ST elevation with PR depression
• D. QT prolongation

Answer: (C)

Acute inflammation of the pericardium creates a current of injury that affects the surface of the heart, leading to widespread changes on the ECG. The hallmark is diffuse, usually concave-up ST-segment elevations across many leads, paired with PR-segment depression in most leads (with PR elevation in aVR often seen). This pattern helps distinguish pericarditis from a myocardial infarction, which typically shows localized, sometimes convex ST elevations with reciprocal ST depressions in opposite leads. The other options don’t fit this inflammatory pattern: ST depression in a subset of leads, no ECG changes, or QT prolongation are not characteristic findings of acute pericarditis.

Acute inflammation of the pericardium creates a current of injury that affects the surface of the heart, leading to widespread changes on the ECG. The hallmark is diffuse, usually concave-up ST-segment elevations across many leads, paired with PR-segment depression in most leads (with PR elevation in aVR often seen). This pattern helps distinguish pericarditis from a myocardial infarction, which typically shows localized, sometimes convex ST elevations with reciprocal ST depressions in opposite leads. The other options don’t fit this inflammatory pattern: ST depression in a subset of leads, no ECG changes, or QT prolongation are not characteristic findings of acute pericarditis.