Emergent causes of Diffuse ST-Segment Elevation
Emergent causes of Diffuse ST-Segment Elevation
Episode 2
September 18, 2011
Differential for NARROW-COMPLEX & REGULAR Tachycardia’s
- Sinus Tachycardia
- Supraventricular Tachycardia
- 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
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