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Updated: May 22, 2026

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

PR depression is useful in the differential diagnosis of myopericarditis and ST elevation myocardial infarction

Pekka Porela1, Ville Kytö, Kjell Nikus

  • 1Department of Medicine, Turku University Hospital, Finland. pekka.porela@tyks.fi

Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc
|April 28, 2012
PubMed

Insights

PR segment depression on ECG is a key indicator for differentiating acute myopericarditis from ST-elevation myocardial infarction (STEMI). This simple analysis aids rapid bedside diagnosis in emergency settings.

Area of Science:

  • Cardiology
  • Electrocardiography
  • Emergency Medicine

Background:

  • PR segment deviation is a common, yet often overlooked, electrocardiogram (ECG) finding in acute myopericarditis.
  • This finding is rare in the acute phase of ST-elevation myocardial infarction (STEMI).
  • Rapid differential diagnosis between acute myopericarditis and STEMI is critical in emergency settings.

Purpose of the Study:

  • To evaluate the diagnostic utility of PR segment depression in distinguishing between acute myopericarditis and STEMI in patients presenting with ST elevations.

Main Methods:

  • Included 34 patients with acute myopericarditis and 46 STEMI patients with ST elevations.
  • Analyzed the initial ECG from the emergency room, focusing on PR segment characteristics.
  • Confirmed diagnoses through clinical follow-up, troponin levels, and coronary angiography for STEMI.

Main Results:

  • PR depression was most frequent in lead II (55.9%) in myopericarditis patients.
  • PR depression in any lead showed high sensitivity (88.2%) but low specificity (78.3%) for myopericarditis.
  • Combined PR depressions in precordial and limb leads offered strong predictive power (96.7% positive, 90% negative) for differentiating the two conditions.

Conclusions:

  • PR segment analysis is a valuable tool for the differential diagnosis of myopericarditis and STEMI.
  • This simple ECG finding should be incorporated into the diagnostic workup for patients with ST elevations.
Abstract

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