ECG of the Week - 14th October 2013 - Interpretation

This ECG is from a 24 year old male who presents with chest pain.
He is normally fit & well.
Vital signs: BP 134/76 RR 16 Sats 99% RA Temp 36.8
Check out the comments at our original post here.

Click to enlarge

Rate:

• 90

Rhythm:

• Regular
• Sinus Rhythm

Axis:

• Inferior / Right Axis Deviation (~95 deg)

Intervals:

• PR - Normal (~170ms)
• QRS - Normal (80ms)
• QT - 320ms (QTc Bazette ~ 400 ms)

Segments:

• PR Depression Leads II, III, aVF, V2
• PR Elevation possibly in aVR
• Concave ST Elevation leads II, III, aVF, V2-6 
• ST Depression aVR

Additional:

• Downsloping of the T-P segment
• Spodick's Sign
• Best appreciated in leads II, V3-6

Interpretation:

• Pericarditis

Pericarditis FOAMed

It seems pericarditis is one of the most blogged about ECG findings.
I have no intention of reinventing the wheel, but thought this was a nice ECG to share, so I'm just going to point you to a few discussions / examples / guidelines / reviews on pericarditis, below.

• Life in the Fast Lane - ECG Library
• Pericarditis
• Amal Mattu's EKG Videos
• Episode 52 - ECG finding's in Pericarditis vs STEMI
• Episode 65 - Spodick's Sign
• Episode 68 - STEMI vs Pericarditis: Don't be fooled
• Episode 84 - When Pericarditis isn't Pericarditis
• Dr Ken Grauer's ECG Interpretation Blog
• A 23yr old woman with chest pain
• Dr Smith's ECG Blog
• Is it MI or Pericarditis ?
• Is it MI or Pericarditis 2 ?
• Severe Atypical Chest Pain in a young woman ECG Series
• European Socitey of Cardiology
• Guidelines on the diagnosis and management of pericardial disease 2004
• Pericardial Disease: Diagnosis & Management Review Paper
• Khandaker MH, Espinosa RE, Nishimura RA, Sinak LJ, Hayes SN, Melduni RM, Oh JK. Pericardial Disease: Diagnosis and Management. Mayo Clin Proc. 2010 June; 85(6): 572–593.