The problem of ST segment elevation

This post has been updated and moved here: http://www.ecgmedicaltraining.com/st-segment-elevation-beyond-false-positives/

 

5 Comments

  • How does the Ventricular Aneurysm present on the 12 Lead?

  • Tom B says:

    That is one of the toughest AMI mimics (since it’s caused by an actual previous MI). It usually presents with QS complexes in leads V1-V4 and persistent ST segment elevation. This is where the history is valuable. Dr. Stephen Smith from Hennepin County Medical Center authored “T/QRS ratio best distinguishes ventricular aneurysm from anterior myocardial infarction” (Am J Emerg Med 2005 May;23(3):279-87) which I didn’t quite grasp. He subscribes to the EKG Club but I haven’t gotten around to asking for an in-depth explanation. Thanks for the comment!

  • Ncline7 says:

    Below is an excellent site to help refine you STEMI and STmimic interpritationshttp://www.emergencymedicine.ucla.edu/ECGChallenge/ECGChallenge3.html

  • Anonymous says:

    Hey Tom-When confronted with STE in the precordial leads might it be useful to view posterior leads to determine whether reciprocol changes are present? My thinking is that STE due to LVH/BER etc won't have reciprocol changes while a true injury pattern will.

  • ARSHAD HASAN says:

    1 thing left—Brugada syndrome?????

    And if doubt—Do ENZYMATIC CONFIRMATION

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