Template:ST elevation DDX

ST Elevation

• Myocardial infarct (STEMI)
• Post-MI (ventricular aneurysm pattern)
• Previous MI with recurrent ischemia in same area
• Wellens' syndrome
• Coronary artery vasospasm (eg, Prinzmetal's angina)
• Drugs of abuse (eg, cocaine, crack, meth)
  • Be aware that these can also cause Wellen's
• Pericarditis
• Myocarditis - unless clearly related viral syndrome, can't risk stratify clinically with EKG or troponins and must go to cath lab
• Aortic dissection in to coronary
• LV aneurysm
• Early repolarization
• Left bundle branch block
• Left ventricular hypertrophy (LVH)
• Pneumomediastinum
• Pneumothorax
• Myocardial tumor
• Myocardial trauma
• External compression of artery
• Medications: Tricyclic (TCA) toxicity, Digoxin
• RV pacing (appears as Left bundle branch block)
• Hyperkalemia (only leads V1 and V2)
• Hypothermia ("Osborn J waves")
• Brugada syndrome
• Takotsubo cardiomyopathy