Differential Diagnosis: STEMI vs. acute pericarditis

ECG Weekly Workout with Dr. Amal Mattu


A 45-year-old male presents to the emergency department with sharp, positional, and pleuritic chest pain while doing CrossFit. He is not a smoker and has no known cardiac risk factors. The following ECG was obtained on arrival:

Before watching this week’s video, ask yourself these questions:

  1. What ECG abnormalities do you notice?
  2. What is your differential for the ST-segment abnormalities?
  3. How can you use the ECG to help differentiate acute pericarditis from STEMI?
  4. Would you activate the cath lab?