This post is an answer to the ECG Case 346
- Rate: 120 bpm
- Rhythm: regular sinus rhythm
- Axis: Normal / Inferior
- Intervals:
- PR – Normal (~170ms)
- QRS – Normal (80ms)
- QT – 270ms (QTc Bazette 380 ms)
- Additional:
- ST Elevation in leads I, II, V1-3
- Baseline artifact in precordial leads
- Absence of ST depression
Interpretation
- Sinus tachycardia
- ST segment changes without reciprocal changes
Differential Diagnosis
- Benign Early Repolarisation
- Pericarditis
- ACS – should always be considered when making a diagnosis of pericarditis
What happened next?
The patient underwent a bedside echo which was normal without evidence of pericardial effusion or regional wall motion abnormality. He was subsequently treated as pericarditis with symptomatic improvement.
READ MORE: Know the Differential for ST Segment Elevation: It’s More Than Just ACS
