Advanced Medical Life Support (AMLS)

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A patient complains of persistent chest discomfort and has a fever. Which finding is indicative of pericarditis?

Pain is relieved when supine
Pulsus alternans is present
S3 gallop is auscultated
ST-segment elevation in all leads

The correct answer is: ST-segment elevation in all leads

The presence of ST-segment elevation in all leads is a classic finding for pericarditis. This condition often presents with diffuse ST-segment elevations on an electrocardiogram (ECG), which can be seen in leads that typically do not show changes in other cardiac conditions like myocardial infarction. In pericarditis, these changes reflect inflammation of the pericardium and are a key diagnostic marker. While chest pain relief when supine, the presence of pulsus alternans, or an S3 gallop point to various other cardiac conditions, none of these findings are as directly indicative of pericarditis as the widespread ST-segment elevation. Thus, the ECG finding of ST-segment elevation in all leads helps clarify the diagnosis of pericarditis and distinguishes it from other possible causes of chest discomfort and fever.