Pr-segment Depression in Medicine / Internal Medicine — 58yo Man | Cardiology | SMLE Q#17151

SMLE Question #17151

Medicine / Internal Medicine Cardiology

Objective: OBJ-163

Last updated: February 2026
A 58-year-old man has 6 hours of sharp central chest pain that began 1 week after an upper respiratory infection. The pain worsens when lying flat and improves when sitting up and leaning forward. Cardiac examination reveals a scratchy, high-pitched sound at the left lower sternal border when he leans forward at end-expiration. ECG shows diffuse concave ST-segment elevation with PR-segment depression. What is the most likely diagnosis?

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