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June 11, 2003

Electrocardiographic Diagnosis of Pericarditis—Reply

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289(22):2942-2943. doi:10.1001/jama.289.22.2942-a

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.

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