How can you differentiate acute pericarditis from ACS on ECG?

Prepare for the Emergency Nursing Orientation 3.0 Cardiovascular Emergencies Test. Use interactive flashcards and detailed explanations with multiple choice questions. Enhance your understanding of cardiovascular emergencies and succeed on your exam!

Multiple Choice

How can you differentiate acute pericarditis from ACS on ECG?

Diffuse ST-segment elevations across many leads with concurrent PR-segment depression, plus pleuritic chest pain that improves when sitting up, point to acute pericarditis rather than ACS. The widespread, global pattern reflects inflammation of the pericardium affecting multiple territories, and PR depression (often with PR elevation in aVR) is a distinctive sign of pericardial involvement. The absence of reciprocal ST-segment depressions also helps separate it from an acute coronary syndrome that typically shows localized ST elevations in a coronary territory with opposite-lead depression. The described chest pain that worsens with inspiration and improves when sitting up further supports pericarditis. By contrast, localized ST elevations with reciprocal changes suggest STEMI, and a normal ECG would not explain the inflammatory process, while Q waves in inferior leads imply a prior infarct rather than new pericarditis.

Diffuse ST-segment elevations across many leads with concurrent PR-segment depression, plus pleuritic chest pain that improves when sitting up, point to acute pericarditis rather than ACS. The widespread, global pattern reflects inflammation of the pericardium affecting multiple territories, and PR depression (often with PR elevation in aVR) is a distinctive sign of pericardial involvement. The absence of reciprocal ST-segment depressions also helps separate it from an acute coronary syndrome that typically shows localized ST elevations in a coronary territory with opposite-lead depression. The described chest pain that worsens with inspiration and improves when sitting up further supports pericarditis. By contrast, localized ST elevations with reciprocal changes suggest STEMI, and a normal ECG would not explain the inflammatory process, while Q waves in inferior leads imply a prior infarct rather than new pericarditis.

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