EKG-STE | Bssp

EKG cases

Pending

Causes of ST elevation on EKG

•Cardiac:

–AMI

–Variant (Prinzmetal's) angina

–Acute pericarditis

–LV aneurysm

–LVH

–BBBs (LBBB, RBBB, NSIVCD)

–Early repolarization

•Metabolic:

–HyperK

–Hypothermia (Osborne or "J" w)

–Hyperventilation

•Miscellaneous:

–Acute abdominal disorders (pancreatitis, cholecystitis, peritonitis)

–CNS hemorrhage

–Meds (type I anti-arrhythmic agents, isoproterenol)

–Body habitus

–Idiopathic

?VT after cardiac arrest

60 YOM with poorly controlled DM, hyperlipidemia, COPD and secondary polycytemia brought to ER after cardiac arrest. S/p AED ressucitation and defibrillation x7. Initial EKG with questionable VT leading to cardioversion but retrospectively probably just major tombstone STE. Ressucitation for VT for 30 min prior to cardiology being called. Repeat EKG with ongoing ressucitation showed clear STEMI inferior with reciprocal changes. Admission labs showed normal lytes but for Na 133, pH 7.17, pCO2 68. Emergency cath showed TO RCA, s/p successful PTCI with BMS. Hypothermia protocol. RV dysfunction likely due to right ventricular infarct. Poor neurologic response and family withdrew care 3 days latter.