Which statement is true about pericarditis?

• A. It is never associated with chest pain
• B. It can present with diffuse ST elevations on ECG
• C. It is always due to infectious causes
• D. It never responds to NSAIDs

Answer: (B)

Pericarditis classically causes chest pain that is sharp and pleuritic, often worsened by lying flat and relieved by sitting up and leaning forward. On ECG, inflammation of the pericardium tends to produce diffuse, widespread elevations of the ST segments across many leads, frequently with concurrent PR-segment depression. This diffuse pattern helps distinguish pericarditis from a myocardial infarction, which usually shows regional (localized) ST elevations that correspond to a specific coronary territory and may have reciprocal changes.

The condition is not restricted to infectious causes; many cases are idiopathic or viral, but autoimmune, uremic, post–myocardial infarction (Dressler syndrome), and other etiologies exist. Treatments focus on reducing inflammation and pain, with NSAIDs as first-line therapy, often combined with colchicine; corticosteroids are reserved for certain situations or if NSAIDs/colchicine are ineffective or contraindicated.

So the statement describing diffuse ST elevations on ECG captures a characteristic finding of pericarditis, while the other statements do not align with its typical presentation or management.