Emergent causes of Diffuse ST-Segment Elevation
Episode 2
​September 18, 2011

Differential for NARROW-COMPLEX & REGULAR Tachycardia’s

  1. Sinus Tachycardia
  2. Supraventricular Tachycardia
  3. Atrial flutter with 2:1 Conduction
Differential for Diffuse ST-Segment Elevation (STE)
  • Large STEMI
    • Sick patient, often with reciprocal changes
    • Morphologies are classically convex or horizontal, but can be concave as well​
    • STE in lead III>II, is highly indicative of STEMI
  • Pericarditis / Myocarditis
    • No reciprocal changes
    • Concave upwards STE
    • ​Diffuse PR-depression
    • STE Lead II>III
  • Early repolarization
    • ​No reciprocal changes
    • Concave upwards STE
    • STE in Lead II>III
    • Usually seen in young males
    • Similar appearance on old ECGs
  • Ventricular aneurysm
    • Generally no reciprocal changes
    • Look for history of prior MI​
    • Large Q-waves
  • LBBB
  • LVH
  • Brugada syndrome
  • Hyperkalemia
Look for reciprocal changes to narrow your differential

Want more? Check out this related video…

 
Emergent causes of Diffuse ST-Segment Elevation
Episode 2
​September 18, 2011

Differential for NARROW-COMPLEX & REGULAR Tachycardia’s

  1. Sinus Tachycardia
  2. Supraventricular Tachycardia
  3. Atrial flutter with 2:1 Conduction
Differential for Diffuse ST-Segment Elevation (STE)
  • Large STEMI
    • Sick patient, often with reciprocal changes
    • Morphologies are classically convex or horizontal, but can be concave as well​
    • STE in lead III>II, is highly indicative of STEMI
  • Pericarditis / Myocarditis
    • No reciprocal changes
    • Concave upwards STE
    • ​Diffuse PR-depression
    • STE Lead II>III
  • Early repolarization
    • ​No reciprocal changes
    • Concave upwards STE
    • STE in Lead II>III
    • Usually seen in young males
    • Similar appearance on old ECGs
  • Ventricular aneurysm
    • Generally no reciprocal changes
    • Look for history of prior MI​
    • Large Q-waves
  • LBBB
  • LVH
  • Brugada syndrome
  • Hyperkalemia
Look for reciprocal changes to narrow your differential

Want more? Check out this related video…

 
  1. old-ekgumem posted this
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