Diffuse ST-segment elevations on ECG are most consistent with which diagnosis?

Diffuse ST-segment elevations on ECG are most consistent with which diagnosis?

• A. STEMI
• B. Pericarditis
• C. Myocarditis
• D. Early repolarization

Answer: (B)

Diffuse ST-segment elevations across many ECG leads point to inflammation of the pericardium, i.e., acute pericarditis. Because the injury affects the heart globally, the ST elevations are widespread rather than confined to one coronary territory. The pattern is often concave upward and can be accompanied by PR-segment depression, which helps distinguish it from other causes. In contrast, a STEMI shows ST elevations in a specific regional distribution with possible reciprocal changes, and early repolarization, though it can elevate the J point, is usually mild, benign, and not accompanied by PR depression. Myocarditis may sometimes mimic pericarditis, but the classic diffuse elevation with PR depression is most characteristic of pericarditis.

Diffuse ST-segment elevations across many ECG leads point to inflammation of the pericardium, i.e., acute pericarditis. Because the injury affects the heart globally, the ST elevations are widespread rather than confined to one coronary territory. The pattern is often concave upward and can be accompanied by PR-segment depression, which helps distinguish it from other causes. In contrast, a STEMI shows ST elevations in a specific regional distribution with possible reciprocal changes, and early repolarization, though it can elevate the J point, is usually mild, benign, and not accompanied by PR depression. Myocarditis may sometimes mimic pericarditis, but the classic diffuse elevation with PR depression is most characteristic of pericarditis.