ECG Strip 15
A patient (male, 32 years old) has been hospitalized for a pressure chest pain located behind the sternum. The pain woke him from the sleep. He is subfebrile and suffers from flu-like symptoms. The ECG contains discrete elevations of ST interval in II, III and aVF. Cardiac enzymes are elevated and so is CRP. Differential diagnosis is either STEMI infarction of the inferior heart wall and pericarditis. STEMI is less probable because of young age and other present symptoms. However, it is not typical for pericarditis to have the ST elevations only in leads corresponding with the heart inferior wall. The patient was pharmacologically treated as STEMI and sent to local cardiovascular center for further investigation. Coronary angiography was performed with a negative outcome, which supports the theory of pericarditis.