Emergency Medicine Practice Test 2026 – Complete Exam Preparation

The presence of chest pain accompanied by a scratchy sound upon auscultation is highly suggestive of pericarditis, an inflammation of the pericardium which can cause referred pain and characteristic auscultatory findings.

In pericarditis, the typical ECG changes include diffuse ST elevation across multiple leads and PR segment depression. The diffuse ST elevation is due to the inflammation affecting the heart muscle and can be observed in most leads, rather than localized to specific areas. Additionally, PR segment depression is often noted as a direct result of the inflammatory process irritating the pericardium and the corresponding atrial tissue.

This electrical disturbance reflects the widespread nature of the inflammatory process, distinguishing pericarditis from other conditions that might manifest with chest pain or atypical heart sounds. Since none of the other options align with the classic presentation or ECG findings associated with pericarditis, they do not apply in this case. This background supports the selection of diffuse ST elevation and PR depression as the correct answer for the suspected ECG changes in a patient presenting with these symptoms.