ST elevation is not always due to STEMI. Other causes to be kept in mind to prevent the undue complications of thrombolysis. wrong patient and wrong management

1. OTHER CAUSES OF ST
ELEVATION
Dr.N.Praveen
MD,DM
Associate Professor of Cardiology
Osmania General Hospital, Hyderabad

2. ST Elevation
• Coronary artery spasm
• Acute pericarditis
• J point elevation
• Left ventricular hypertrophy
• Myocarditis
• Brugada syndrome
• Hyperkalemia
• Acute pulmonary embolism
• Repolarization syndromes in setting of bundle branch blocks
• Acute pancreatitis.

3. Coronary artery spasm

5. Acute Pericarditis

6. Spodick’s sign

8. Benign Early Repolarization

9. BER vs Pericariditis
• ST segment / T wave ratio:
• The vertical height of the ST segment elevation (from the end of the
PR segment to the J point) is measured and compared to the
amplitude of the T wave in V6.
• A ratio of > 0.25 suggests pericarditis
• A ratio of < 0.25 suggests BER

11. Fish hook pattern

12. J WAVE

13. LVH WITH STRAIN

14. Myocarditis

15. Brugada syndrome

17. Acute Pulmonary thromboembolism