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Today, we reprise an ECG originally published in 2012.  We welcome comments and questions, and all questions will be answered by one of our experts.

This 20-year-old man was feeling "sick", with a fever and malaise.  He also complained of chest pain, which was partly relieved by sitting forward.  He had a recent history of IV drug use.  This ECG shows the tell tale signs of pericarditis:  1)  widespread ST elevation without the other signs of M.I.  He has no T wave inversions, reciprocal ST depressions, or pathological Q waves.    2) He has a subtle depression of his PR segments, which can be a difficult sign to see.  3) Spodick's Sign, a downsloping of the RP segment.

Additionally, his ST elevations are similar throughout the ECG, in height and in shape.  Acute M.I. usually shows variations in the ST changes as we look closer to the center of the injury, or at the outskirts.

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