WBR0035

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Author Raviteja Reddy Guddeti MBBS, Aarti Narayan MBBS
Exam Type USMLE Step 3
Main Category Community Medical Health Center
Sub Category Cardiovascular
Prompt A 65 year old male presents with fever, weakness, and chest pain that is pleuritic in nature. The pain is relieved by sitting up and leaning forward. The patient describes the pain as sharp and brief. Auscultation reveals friction rub. What is the pathognomonic EKG finding in this patient?
Answer A Universal ST segment elevation
Answer A Explanation Although universal ST segment elevation is commonly seen in acute pericarditis, it is not a pathognomonic finding.
Answer B T wave inversion and poor R wave progression.
Answer B Explanation T wave inversion and poor R wave progression suggests ischemia, and is not pathognomonic for acute pericarditis.
Answer C PR depression
Answer C Explanation PR depression is the correct answer.
Answer D Presence of a Q wave
Answer D Explanation Presence of a Q wave suggests an old infarct, and is not pathognomonic for acute pericarditis.
Answer E Poor R-wave progression
Answer E Explanation Poor R-wave progression can imply an old anterior MI, and is not pathognomonic for acute pericarditis.
Right Answer C
Explanation The correct answer is PR depression, as the patient has acute pericarditis. PR depression is an EKG finding which is pathognomonic in acute pericarditis, even though ST elevation is often seen in all leads universally. ST segment elevation is seen in other cardiac conditions such as STEMI, pulmonary embolism, therefore this finding is not pathognomonic.

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