Diffuse ST-segment elevations with PR depressions across many leads. What condition is this classic for?

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Diffuse ST-segment elevations across many leads with PR-segment depressions points to acute pericarditis. The inflamed pericardial sac creates a global injury current that elevates the ST segments in nearly all leads, usually with a concave upward shape. The PR-segment depression occurs because the inflammatory process also affects the atrial region, producing injury currents that depress the PR interval in most leads (often with PR elevation in aVR). This combination is distinctive for pericarditis and helps differentiate it from myocardial infarction, where ST elevations localize to a specific coronary territory and reciprocal depressions can appear in opposite leads, rather than a diffuse pattern with PR depression. U waves from hypokalemia and early repolarization don’t produce this PR-depression pattern and have their own typical, different features.