Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
To the Editor: In his Contempo Updates article
about acute pericarditis, Dr Spodick1 did
not discuss early repolarization pattern of the electrocardiogram (ECG) as
an item in the differential diagnosis. Early repolarization pattern is common
among healthy men who may coincidently have musculoskeletal chest pain. Characteristic
ECG patterns include J point and ST segment elevation with upward concavity
and notching at terminal QRS complex.2,3 In
fact, the ECG presented by Spodick is indistinguishable from an early repolarization
pattern except for the PR segment elevation in the aVR lead. The ECG should
always be interpreted in the context of clinical symptoms.
Mansi I. Electrocardiographic Diagnosis of Pericarditis—Reply. JAMA. 2003;289(22):2942-2943. doi:10.1001/jama.289.22.2942-a