PQ-segment elevation and depression

Patient

61-year-old man having presented an influenza-like illness 15 days earlier; hospitalization for chest pain;

Trace

Sinus rhythm, diffuse PQ segment depression (maximum in leads I, II and inferior limb leads) with PQ segment elevation in aVR and V1, moderate lateral ST segment elevation; possible alternating QRS amplitude visible in V1 and V2;

Exergue

The PR segment is usually isoelectric. A depression or elevation should evoke the diagnosis of acute pericarditis or atrial infarction (most often associated with a posteroinferior ventricular infarction).