View source for WBR0035

{{WBRQuestion
|QuestionAuthor=Raviteja Reddy Guddeti MBBS, Aarti Narayan MBBS
|ExamType=USMLE Step 3
|MainCategory=Community Medical Health Center
|SubCategory=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?
|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.
|AnswerA=Universal ST segment elevation
|AnswerAExp=Although universal ST segment elevation is commonly seen in acute pericarditis, it is not a pathognomonic finding.
|AnswerB=T wave inversion and poor R wave progression.
|AnswerBExp=T wave inversion and poor R wave progression suggests ischemia, and is not pathognomonic for acute pericarditis.
|AnswerC=PR depression
|AnswerCExp=PR depression is the correct answer.
|AnswerD=Presence of a Q wave
|AnswerDExp=Presence of a Q wave suggests an old infarct, and is not pathognomonic for acute pericarditis.
|AnswerE=Poor R-wave progression
|AnswerEExp=Poor R-wave progression can imply an old anterior MI, and is not pathognomonic for acute pericarditis.
|RightAnswer=C
|Approved=Yes
}}