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Causes of ST Elevation

Shyam Murali, MD

Dr. de Saint Victor (AKA dSV), our local ECG expert, makes use of spaced repetition to help us remember the many causes of ST elevation. As a standing segment of all of his lectures, this stood out to us as the perfect first educational post:

 

Causes ST elevation:

•Usual suspects

       -STEMI

       -Vasospasm

       -Pericarditis/myocarditis

       -Benign early repolarization

•Lefties and Righties

       -Left bundle branch block

       -Left ventricular aneurysm

       -Left ventricular hypertrophy

       -Pulmonary embolism, right heart strain

•H's

       -Hyperkalemia

       -Hypercalcemia

       -Hypothermia

       -Na+ cHannelopathies

•Names

       -Brugada syndrome

       -Takotsubo cardiomyopathy

•Disasters (Spiked helmet sign*)

       -Intracranial abnormalities

       -Post-cardioversion/post-epinephrine

       -Aortic dissection

       -Massive GI bleed

 

 

 

 

 

 

 

 

 

 

 

 

 

*Spiked helmet sign can be seen in severe noncardiac illness

Other resources to check out:

  1. "The ST Segment" by E Burns. Life in the Fast Lane: https://litfl.com/st-segment-ecg-library/

 

References

  1. Littmann L, Monroe MH. The “Spiked Helmet” Sign: A New Electrocardiographic Marker of Critical Illness and High Risk of Death. Mayo Clinic Proceedings. 2011;86(12):1245-1246. doi:10.4065/mcp.2011.0647

11/08/18

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