A 46 year old man presents with diffuse chest pain at rest and recent history of cough, fever and rhinorrhea lasting for 3 days. ECG shows?
Sinus rhythm at approx. 75 beats/min. PR interval is prolonged to 200 msec. The QRS axis and intervals are normal. ST elevations with concave upward morphology are seen in I and aVL, II and aVF, and V2 through V6. The upward concavity of the ST segment, the PR-segment depression, the lack of Q waves, and the diffuse nature of the ST-segment elevation in more than one coronary aery distribution make pericarditis the likely etiology. Patients with pericarditis will complain of chest pain, typically described as sharp and pleuritic. Radiation of the pain is towards trapezius ridge. The pain is improved with sitting up and leaning forward and worsened by leaning backward.
Acute pericarditis
Constrictive pericarditis
Takotsubo cardiomyopathy
Cor-pulmonale
Disease of pericardium