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Reveal Answer There are features suggestive of pericarditis: Widespread concave ST elevation Subtle downsloping PR depression in limb (I, aVL) and precordial (V3-6) leads Subtle PR elevation in aVR But also features suggestive of BER: ST elevation is markedly more prominent in precordial leads (especially V2-5) J-wave notching with fish-hook pattern in V3-4 Prominent precordial T waves ST / T wave ratio of 0.16 These ECG appearances could be caused by BER alone, although it is possible that this ECG represents BER with superimposed pericarditis
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