Pericarditis

Report:

Sinus rhythm 85/min

ST segment elevation suggestive of acute pericarditis

LVH voltage

RL2 > 15 mm

Comment:

The typically concave-upward ST elevation is so widespread and marked that the only differential diagnosis, early repolarisation, is most unlikely. Further, the PR segment displacement is also present (albeit, as always, remaining just an exaggeration of the normal pattern); this would be unexpected in a 20 year old with normal heart. The computer went for early repolarisation, with the usual computer ‘explanation’: ST elevation, age 16-55!

Leads with deep S waves are often exempt from ST elevation in pericarditis, like aVL or V1 here.

36. 57 year old lady with unexplained neurological symptoms

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