Fellow in Trauma and Surgical Critical Care - University of Pennsylvania,
Senior Editor - CriticalCareNow.com,
Writer - RebelEM.com,
Saxophonist, EDM remixer, husband, puppy father, and new human father
The Pre-brief
One of my favorite attendings and ECG expert, Dr. de Saint Victor (AKA dSV), makes use of spaced repetition to help us remember the many causes of ST elevation. As a standing segment of all of his lectures, his list of 18 causes of ST elevation have been drilled into our minds. Of note, only ONE of these is myocardial infarction! In this previous Vitals post, we covered causes of troponin elevation; today we are going to cover the causes of ST elevation.
Causes ST elevation:
The Usual Suspects
STEMI
Vasospasm
Pericarditis/myocarditis
Benign early repolarization
Lefties and Righties
Left bundle branch block
Left ventricular aneurysm
Left ventricular hypertrophy
Pulmonary embolism, right heart strain
H’s
Hyperkalemia
Hypercalcemia
Hypothermia
Na+ cHannelopathies
Names
Brugada syndrome
Takotsubo cardiomyopathy
Disasters (Spiked helmet sign)
Intracranial abnormalities
Post-cardioversion/post-epinephrine
Aortic dissection
Massive GI bleed
Spiked helmet sign
STEMI mimics
The Debrief
Consider dividing up the causes of ST elevation into the following categories:
