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PR depression with multi‑lead ST elevation and ST depression in aVR: Is it always acute pericarditis?

Abstract：

:The classic electrocardiographic (ECG) manifestation of stage I of acute pericarditis is diffuse ST elevation and PR depression with ST depression in lead aVR. One of the most common conditions, that is often confused with acute pericarditis, is the benign diffuse ST elevation, termed "early repolarization with ST elevation" (ERSTE). ERSTE often presents with diffuse ST elevation in the inferior and anterolateral leads, with or without terminal QRS notching or slurring. As ERSTE often presents with ST elevation in leads I and II, frequently there is concomitant ST depression in lead aVR, similar to the acute pericarditis ECG pattern. Moreover, PR depression in the inferior leads and/or PR elevation in lead aVR is often seen. Here we describe four patients with ERSTE, all had ST elevation in II with either ST elevation or isoelectric ST in lead I and concomitant ST depression in aVR. Two also had PR depression in the inferior leads. None of the patients had clinical symptoms or signs of acute pericarditis. In conclusion, diffuse ST elevation in the inferolateral leads associated with ST depression in aVR and even with PR segment depression is commonly found in ERSTE and should not be considered as pathognomonic of only acute pericarditis.

journal_name

J Electrocardiol

journal_title

Journal of electrocardiology

authors

Birnbaum Y,Perez Riera AR,Nikus K

doi

10.1016/j.jelectrocard.2019.01.085

subject

Has Abstract

pub_date

2019-01-01 00:00:00

pages

13-17

eissn

0022-0736

issn

1532-8430

pii

S0022-0736(18)30752-0

journal_volume

54

pub_type

杂志文章

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