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This post is an answer to the ECG Case 213

• Rate: 90 bpm

• Rhythm:
  • Regular
  • Sinus Rhythm
• Axis:
  • Inferior / Right Axis Deviation (~95 deg)

• Intervals:
  • PR – Normal (~170ms)
  • QRS – Normal (80ms)
  • QT – 320ms (QTc Bazette ~ 400 ms)

• Segments:
  • PR Depression in Leads II, III, aVF, V2
  • PR Elevation possibly in aVR
  • Concave ST Elevation in leads II, III, aVF, V2-6 
  • ST Depression in aVR

• Additional:
  • Down-sloping of the T-P segment
    • Spodick’s Sign
    • Best appreciated in leads II, V3-6

Interpretation:

Probably Pericarditis because of the Spodick’s Sign (down-sloping of the T-P segment in leads II, V3-6) and PR depression.

READ MORE: Know the Differential for ST Segment Elevation: It’s More Than Just ACS

SIMILAR CASES:

• ECG Case 171: Electrical Alternans indicating Pericardial Effusion
• ECG Case 100: Atrial Fibrillation and Pericarditis