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In Reply: I agree with Dr Mansi that in a few cases stage 1 acute pericarditis may be indistinguishable from early repolarization.¹ However, apart from any different clinical syndromes, there are numerous ECG criteria that usually distinguish between them. These include the degree and ubiquity of PR segment deviations.² Furthermore, marked and widespread PR depressions (such as were shown in the Figure 1 in my article) are never observed in early repolarization.² However, sometimes only ST (J point) deviations occur in acute pericarditis without PR deviations and these may resemble those observed in early repolarization.^{1, 3} Still, in such ECGs and in nearly all patients with acute pericarditis, the J point height in lead V₆ measures more than 25% of the height of the T peak from the baseline.⁴ Thus, there are several reasons that the ECG in my article is clearly diagnostic of acute pericarditis.⁴

Finally, "early repolarization" is a . . . [Full Text of this Article]

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Electrocardiographic Diagnosis of Pericarditis
Ishak Mansi
JAMA. 2003;289(22):2942.
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