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Jay - I agree that pericarditis should be the primary consideration.
However, I wonder how you can exclude rare possibilities causing cardiac
ischemia without further diagnostic studies - if the ECG very strongly
suggests an inferior AMI. You state that the ECG changes affect the
anterior, inferior and lateral wall - does that imply that the pathology
affects those 3 areas of the LV wall? Could the ST depressions in the
anteroseptal and lateral leads not simply be due to reciprocal changes
(due to the fact that those leads face the endocardial surface of the
inferior wall)? How accurate is echocardiography in excluding
pericarditis if there is no pericardial effusion? Also, does the dilated
cardiomyopathy associated with Duchenne's muscular dystrophy actually
cause a ventricular aneurysm involving the inferior wall (thereby
causing ST segment elevations in the inferior leads)? Are there cases
described in the medical literature that demonstrate that particular
complication and those specific ECG features?

Jeff.

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