Crucial Exams

BCEN CEN Practice Question

An adult patient presents to the emergency department with sharp, pleuritic chest pain that improves when leaning forward. The initial 12-lead ECG shows diffuse concave ST-segment elevations in leads I, II, aVL, aVF, and V3-V6. Which additional ECG finding, when present across multiple leads, most strongly supports the diagnosis of acute pericarditis rather than ST-elevation myocardial infarction or early repolarization?

  • New onset bundle-branch block accompanying the ST elevation

  • Development of pathologic Q waves in the leads with ST elevation

  • Reciprocal ST-segment depression in leads II, III, and aVF

  • PR-segment depression in multiple limb and precordial leads

BCEN CEN
Cardiovascular Emergencies
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