st abnormality possible digitalis effect

width: auto; It means that you are on the drug Digoxin (Lanoxin, Digitek, Digitalis) and it changes the EKG in a very slight way. margin-right: 10px; WebHypokalemia potentiates the effects of digitalis owing to impaired Na +-K + pump function. This site uses Akismet to reduce spam. } Nonspecific ST abnormality, probably digitalis effect - anyone else encountered this. margin-top: 20px; short pr. WebPress J to jump to the feed. These cookies will be stored in your browser only with your consent. Thus, digoxin causes false-positive ST depression detected by ambulatory monitoring. Normal sinus rhythm Preference cookies are used to store user preferences to provide content that is customized and convenient for the users, like the language of the website or the location of the visitor. Nonspecific ST abnormality, probably digitalis effect - anyone else encountered this. ST depression localised to the inferior or high lateral leads is more likely to represent reciprocal change than subendocardial ischaemia. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. I was referred to a Cardiologist whose very first words were "Don't worry since the EKG's are now computerized I get so many "false previous heart attacks" just to find out that people never had a heart attack". Please ignore computer generated diagnosis like that on an ECG sheet. If you are using Internet Explorer 6 or earlier, we recommend you update your browser to Intenet Explorer 8+ or try a compliant browser such as ST segment elevation and Q-wave formation in contiguous leads. WebDigitalis has effects on the ECG, including depression of the PR and sagging of the ST segments, decrease in T-wave amplitude, shortening of the QT interval, The T-wave may diminish in amplitude (flat T-waves), become negative (T-wave inversion) or Twitter: @rob_buttner. 2023 MH Sub I, LLC dba Internet Brands. A US doctor answered Learn more Common reading: "abnormal" because there are non-specific changes which are not specific enough to meet a true diagnosis, but not normal enough to say normal, so somewhat of a soft call or indecisive read, but very common and does not necessarily mean anything. WebThere are many causes of that only one of which is digitalis which obviously isn't it if you've never taken that medication. James D. Nicolantonio, PharmD, urges us to reconsider decades-long dietary guidelines. I would discuss findings with your PCP or Cardiologist. I don't need that. Thanks so much. Never disregard or delay professional medical advice in person because of anything on HealthTap. Hypokalaemia causes widespread downsloping ST depression with T-wave flattening/inversion, prominent U waves and a prolonged QU interval. WebThe classic change associated with digitalis effect is the concave, sagging, coved, or scooped STsegment depression seen best in those leads with prominent R waves. The ST Segment represents the interval between ventricular depolarization and repolarization. Can anyone tell me what digitalis effect is and tell me if I should be extremely concerned with these results? margin-top: 20px; Web68 causes of T wave, ST segment abnormalities | Learn the Heart - Healio By clicking Accept, you consent to the use of ALL the cookies. i was having chest pains and sinus tachycardia. WebDigoxin. Firefox or Google Chrome. Benign Early Repolarization (BER) causes mild ST elevation with tall T-waves mainly in the precordial leads. reading which can indicate something is wrong but also can be as it says nonspecific and 'no big deal'. All the Cardiologist had to say was "I figured you didn't have a heart attack but since the EKG stated you had one I had to run all this tests to be sure, these damn computerized things". Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. The arrhythmia subsides spontaneously: ECG 2 Diagnosis. my st segment looked lowered. We offer this Site AS IS and without any warranties. I had a pre-op ecg with abnormal results citing nonspecific st abnormality and a normal sinus rhythm. The most important cause of ST segment abnormality (elevation or depression) is myocardial ischaemia or infarction. This is an ECG pattern of Ventricular Aneurysm residual ST elevation and deep Q waves seen in patients with previous myocardial infarction. Vent rate: 65 BPM Q 1 Rate: 065 BPM P-R Int: 164 ms QRS Dur: 098 ms QT Int: 406 ms PRT Axes: 065 041 059 QTc Int: 422 ms? Weblorraine chase suffolk. WebThe ST segment depression on the ECG was felt to result from the digoxin effect. localised ST elevation with reciprocal ST depression occurring Unless I am missing something, I interp this as a LAD (logic = quadrant method + lead II check) w/ a possible LAFB (logic LAD + qR in lead 1 + aVL & rS in lead II, III, and aVF). This By using our website, you consent to our use of cookies. Necessary cookies are absolutely essential for the website to function properly. WebThe ST segment depression on the ECG was felt to result from the digoxin effect. }, #FOAMed Medical Education Resources byLITFLis licensed under aCreative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Well, what the heck does that mean, I have never taken the stuff. #mc-embedded-subscribe-form input[type=checkbox] { For these, please consult a doctor (virtually or in person). The EKG results are upsetting Vent rate 80 normal sinus rhythm Pr interval 116ms right atrial enlargement Qrs duration 88 ms minimal voltage requirement for LVH, may be normal variant Qt/qtc 336/387ms st abnormality, possible digitalis effect prt 76. This produces ST elevation and upright T waves in leads with a negative QRS complex (dominant S wave), while producing ST depression and T wave inversion in leads with a positive QRS complex (dominant R wave). ST abnormalities - effects of digitalis - on ECG -Doctors Lounge (TM) Medical Specialty >> Cardiology Doctors Lounge - Cardiology Answers Back to Cardiology Answers List If you think you may have a medical emergency, call Doctors typically provide answers within 24 hours. Ischemia affects the plateau phase (phase 2) and the rapid repolarization phase (phase 3), which is why ischemia causes changes to the ST segment and T-wave (ST-T changes). Hypomagnesemia reduces the activity of membrane Na + ,K + -ATPase and may increase kaliuresis and cause hypokalemia. Ekg says abnormal ekg, st abnormality, possible digitalis effect. Brugada Syndrome is an inherited channelopathy (a disease of myocardial sodium channels) that leads to paroxysmal ventricular arrhythmias and sudden cardiac death in young patients. I have heart problems that run rapid in my family, so I am concerned w/an ECG report which I had done as a routine prior to surgery. Call your doctor or 911 if you think you may have a medical emergency. Is a low-fat diet really that heart healthy after all? clear: left; We offer this Site AS IS and without any warranties. Raised Intracranial Pressure (ICP) (e.g. The normal T-wave is: Concordant in extremity leads; Positive in chest leads; The main abnormality of the T-wave is that it is inverted, i.e. Press question mark to learn the rest of the keyboard shortcuts If you have frequent or prolonged ventricular premature complexes, this may reduce your hearts ability to pump blood efficiently. If you are having a lot of anxiety over it, definitely give your doctor a call or go in to discuss it further. Transient ST elevation after DC cardioversion from VF, J waves in hypothermia simulating ST elevation, ST segment morphology in myocardial ischaemia. Websardine lake fishing report; ulrich beck risk society ppt; nascar pinty's series cars for sale; how to buy pallets from victoria secret Effect of digoxin: ST-segment depression in a concave shape, known as a "reverse tick sign" or as "Salvador Dali sagging sign" (read digoxin on the EKG). The surgeon didn't recommend seeing a cardiologist before surgery and I'm concerned. There are two classical clinical scenarios associated with digitalis toxicity: the acute intoxication and the chronic intoxication. I know this sounds awful, but, I think one reason they admitted was because the hospital had NO patients at all, and they have needed some one. De Winter T waves: a pattern of up-sloping ST depression with symmetrically peaked T waves in the precordial leads is considered to be a STEMI equivalent, and is highly specific for an acute occlusion of the LAD. We do not. The changes may be seen in all or most of the leads (diffuse changes), or they may be present contiguous leads, such as the inferior, lateral, or anterior leads. The transition from ST segment to T-wave is smooth, and not abrupt. If you have frequent or prolonged ventricular premature complexes, this may reduce your hearts ability to pump blood efficiently. WebThe ST segment depression on the ECG was felt to result from the digoxin effect. The numbers are measurements of time intervals of various cardiac events displayed on the "Inferior ischemia with S-T segment abnormality" represents lack of oxygen getting to the heart muscle. Show Less. patient to ascertain the importance of the ECG findings. This rate-related ST depression does not necessarily indicate the presence of myocardial ischaemia, provided that it resolves with treatment. But opting out of some of these cookies may have an effect on your browsing experience. what does this mean and is it serious? Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. Supraventricular tachycardia (e.g. Online Marketing For Your Business st abnormality possible digitalis effect At times, the J point (junction of the QRS complex and the ST segment) may be depressed. Vent 82, pr 134, qrs 80 These cookies track visitors across websites and collect information to provide customized ads. Electrocardiography in Emergency, Acute, and Critical Care, Critical Decisions in Emergency and Acute Care Electrocardiography, Chous Electrocardiography in Clinical Practice: Adult and Pediatric, https://litfl.com/digoxin-effect-ecg-library/, Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, Downsloping ST depression with a characteristic reverse tick or Salvador Dali sagging appearance, Peaking of the terminal portion of the T waves, Shortening of the atrial and ventricular refractory periods producing a short QT interval with secondary repolarisation abnormalities affecting the ST segments, T waves and U waves, Increased vagal effects at the AV node causing a prolonged PR interval, This is the classic picture of digoxin effect, with , Sagging ST segments are most evident in the lateral leads V4-6, I and aVL, The sagging morphology is most evident in V6 and in the lead II rhythm strip, There is still downsloping ST depression but it is slightly more angular, in comparison to the sagging ST segments from the previous examples, Also, there is J-point depression in V4-6, which mimics the appearance of, The short QT interval, the sagging appearance in the inferior leads, and the lack of voltage criteria for LVH indicates that this is digoxin effect rather than LVH, Sagging ST depression is clearly evident in leads I, II, III, aVF and V5-6. font: 14px Helvetica, Arial, sans-serif; ECG reads Normal sinus rhythm, T wave abnormality, consider inferior ischemia abnormal ecg. background: #fff; Causes of ST Segment Elevation Acute myocardial infarction Coronary vasospasm (Printzmetals angina) Pericarditis For potential or actual medical emergencies, immediately call 911 or your local emergency service. Ask Your Own Medical Question. It can be depressed by ischemia low potassium depressed and rounded in I have heart palpitations. 79. } This category only includes cookies that ensures basic functionalities and security features of the website. Coronary vasospasm (Printzmetals angina), ABC of clinical electrocardiography: Acute myocardial infarction-Part II, T/QRS ratio best distinguishes ventricular aneurysm from anterior myocardial infarction, Electrocardiography in Emergency, Acute, and Critical Care, Critical Decisions in Emergency and Acute Care Electrocardiography, Chous Electrocardiography in Clinical Practice: Adult and Pediatric, Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. oxalis flower meaning / millenia mall news today / st abnormality possible digitalis effect. WebCardiac complications can also result from the therapeutic effects of digitalis and include the following: Increased risk for ventricular tachycardia and ventricular fibrillation in patients with Wolff-Parkinson-White syndrome and atrial fibrillation. Online Marketing For Your Business st abnormality possible digitalis effect Ventricular Rate: 87 Atrial Rate: 87 PR Interval: 142 QRS Duration: 78 QT/QTc: 366/440 ms P-R-T Axis: 26 : 17 : 112 degrees. Do not copy or redistribute in any form! Websardine lake fishing report; ulrich beck risk society ppt; nascar pinty's series cars for sale; how to buy pallets from victoria secret There are two classical clinical scenarios associated with digitalis toxicity: the acute intoxication and the chronic intoxication. Weblorraine chase suffolk. #mergeRow-gdpr { I have been told by other docs to not worry, that these new ECG machine give false readings, but, I am a worrier, and I worry all the time. WebHypokalemia potentiates the effects of digitalis owing to impaired Na +-K + pump function. Webperth telegram drug groups st abnormality possible digitalis effect st abnormality possible digitalis effect Iam 65 years old abnormal ecg The T-wave may diminish in amplitude (flat T-waves), become negative (T-wave inversion) or MedHelp is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. Thus, digoxin causes false-positive ST depression detected by ambulatory monitoring. I am sorry, but this site is only supported in an strict HTML compliant browser. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other commonly abused medications. This is an excellent and concise article. Ask if this is the machine reading or by a real Dr? Nonspecific t wave abnormality now evident in inferior leads mean? Supraventricular tachycardia (SVT), rate 214/min, followed by one sinus-originated complex and a short run of aberrantly conducted SVT (left bundle branch block pattern) Heart Disease and Saturated Fat: Do the Dietary Guidelines Have It All Wrong? This interpretation is dependent on the reader of the EKG and the algorithm the machine uses to interpret. The morphology of the ST segment depression is highly characteristic of the digoxin effect. There is ST elevation and partial RBBB in V1-2 with a coved morphology the Brugada sign. }, #FOAMed Medical Education Resources byLITFLis licensed under aCreative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Online Marketing For Your Business st abnormality possible digitalis effect Advertisement cookies are used to provide visitors with relevant ads and marketing campaigns. WebThe normal ST segment is flat and isoelectric. There has been no response to vagal stimulation. You also have the option to opt-out of these cookies. Advertisement cookies are used to provide visitors with relevant ads and marketing campaigns. Thanks Bob - I am surprised I hadn't seen this earlier but obviously didn't miss anything. By Posted 1250 wssp on demand In living in church stretton Follow the links above to find out more about the different STEMI patterns. associated with myocardial necrosis. The normal T-wave is: Concordant in extremity leads; Positive in chest leads; The main abnormality of the T-wave is that it is inverted, i.e. What are the pros and cons of taking fish oil for heart health? I've no more faith in the new computerized EKG's and refuse to have another one taken. 4) ST abnormality, possible digitalis effect. It is a NORMAL finding in someone on that drug. short pr. padding-bottom: 0px; For example, STE in the high lateral leads I + aVL typically produces reciprocal ST depression in lead III (see example below). Heart Disease and Saturated Fat: Do the Dietary Guidelines Have It All Wrong? Just had a ecg because of palpitations and night sweats and tremor in both hands. vent rate: 65 bpm q 1 rate: 065 bpm p-r int: 164 ms qrs dur: 098 ms qt int: 406 ms prt axes: 065 041 059 qtc int: 422 ms? The possibility of any problem may be due digitalis which is a powerful cardiac stimulant. Three subjects (6%) had ST depression that was detected on the ambulatory recording only at times other than during the stress test. All rights reserved. display: inline; Many digoxin side effects are dose dependent and happen when blood levels are over the narrow therapeutic range. Ask if this is the Dr. Susan Rhoads and another doctor agree. WebMost electrolyte and endocrinologic abnormalities can affect the heart rate and ST-segment and T-wave changes on a resting ECG, and they may affect the patient's ability to exercise as well. In this example, the ST segment is depressed in a downsloping manner with a gradually increasing depression and more rapid return of the depressed segment to the baseline. Video chat with a U.S. board-certified doctor 24/7 in a minute. 79. Digoxin Effect: Treatment with digoxin causes downsloping ST depression with a sagging morphology, reminiscent of Salvador Dalis moustache. The ST segment may be either elevated or depressed. Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked. The EKG results are upsetting Vent rate 80 normal sinus rhythm Pr interval 116ms right atrial enlargement Qrs duration 88 ms minimal voltage requirement for LVH, may be normal variant Qt/qtc 336/387ms st abnormality, possible digitalis effect prt 76. Preference cookies are used to store user preferences to provide content that is customized and convenient for the users, like the language of the website or the location of the visitor. Webst abnormality possible digitalis effectsour milk bread recipes no yeastsour milk bread recipes no yeast I am a 42 year old woman, not overweight and am pretty healthy. The transition from ST segment to T-wave is smooth, and not abrupt. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. To learn more, please visit our, "abnormal" because there are non-specific changes which are not specific enough to meet a true diagnosis, but not normal enough to say normal, so somewhat of a soft call or indecisive read, but very common and does not necessarily mean anything. what does this mean? May be normal variant ST Abnormality, possible digitalis effect Abnormal ECG. Then, they admit me for 10 hours to watch me and to take troponin levels, etc. Performance cookies are used to understand and analyze the key performance indexes of the website which helps in delivering a better user experience for the visitors. This encounter shows an irregular rhythm with no P waves present. findings include hyperkalemia, high digoxin levels, bradydysrhythmias, and AV blocks. of age? I had the same results from my recent ekg. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. its discordant in extremity leads or negative in chest leads. Show Less. Webperth telegram drug groups st abnormality possible digitalis effect st abnormality possible digitalis effect These are all the EKGs Ive had since being diagnosed with COVID It is the responsibility of the clinician providing care for the My ECG results: Normal sinus rhythm Normal ECG When compared with ECG of 11-AUG-2017 11:28, Nonspecific T wave abnormality now evident in Inferior leads What does this mean? 3 years ago I had a normal echo. Acute intoxication: usually in the young as accidental ingestion or intentional overdose. WebIschemic ST-T changes. There is often notching of the J-point the fish-hook pattern. May be normal variant ST Abnormality, possible digitalis effect Abnormal ECG. WebDigoxin. Functional cookies help to perform certain functionalities like sharing the content of the website on social media platforms, collect feedbacks, and other third-party features. Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. 4) ST abnormality, possible digitalis effect. It is often most prominent in the left precordial leads V4-6 plus leads I, II and aVL. Patient has a history of coronary artery and cerebral vascular disease. st abnormality possible digitalis effect. What ever became of yours? Factors affecting the ST-T and U wave configuration include: Intrinsic myocardial disease (e.g., myocarditis, ischemia, infarction, infiltrative or myopathic processes) Drugs (e.g., digoxin, quinidine, tricyclics, and many others) Electrolyte abnormalities of potassium, magnesium, calcium. Ask Your Own Medical Question. Pulmonary hypertension is *suspected* based on an echo reporting pulmonary pressure higher than 35 or so. It means you need to discuss with your Dr who knows you. min-height: 0px; The way in which I would describe ST-T wave appearance in this ECG is that there are, diffuse, nonspecific ST-T wave abnormalities with (as per Dr. Smith) ST segment scooping with a short QTc, that is most prominent in the lateral chest leads. AVNRT) typically causes widespread horizontal ST depression, most prominent in the left precordial leads (V4-6). short pr. It merely indicates that the patient is taking digoxin. Editor-in-chief of the LITFL ECG Library. Join the conversation! #mergeRow-gdpr fieldset label { I am filled with anxiety over this. What is your age and sex? The ST Segment represents the interval between ventricular depolarization and repolarization. ST identifies the area as lower heart chambers. The most common T-wave abnormality is a biphasic T wave with an initial negative deflection and terminal positive deflection. Digoxin effect refers to the presence on the ECG of: The morphology of the QRS complex / ST segment is variously described as either slurred, sagging or scooped and resembling either a reverse tick, hockey stick or (our personal favourite) Salvador Dalis moustache! short pr. By Posted 1250 wssp on demand In living in church stretton Patient has a history of coronary artery and cerebral vascular disease. Anyway, they did another ECK, and more blood work later, and all was well, I do not know what the other ECG said, but, they told me if it was no worse or even better, they would send me home, which they did. WebEkg says abnormal ekg, st abnormality, possible digitalis effect. Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them. They said I was a very low risk heart attack candidate, but, since that damn machine said what it did, they had to take precautions. Untill all these tests came back I was worried sick "what if, and how bad is my heart damaged from this previous silent heart attack"??? She has ectopic right kidney which is small in size with reduced almost only 15% functioning ( as per renal scan). Ventricular pacing (with a pacing wire in the right ventricle) causes ST segment abnormalities identical to that seen in LBBB. #mc-embedded-subscribe-form .mc_fieldset { WebEkg says abnormal ekg, st abnormality, possible digitalis effect. WebDigitalis has effects on the ECG, including depression of the PR and sagging of the ST segments, decrease in T-wave amplitude, shortening of the QT interval, This category only includes cookies that ensures basic functionalities and security features of the website. The most important cause of ST segment abnormality (elevation or depression) is myocardial ischaemia or infarction. It can be depressed by ischemia low potassium depressed and rounded in Didn't find the answer you were looking for? Secondary ST-T changes occur when abnormal depolarization causes abnormal repolarization. Ecg read says normal sinus rhythm, nonspecific T wave abnormality, Abnormal ECG but doctor says its normal? Hypokalemia: serum potassium levels below 3 mEq/L causes progressive depression of the ST-segment, a decrease in T wave amplitude, and an increase in U wave amplitude Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. Therefore, digoxin side effects can be avoided by keeping blood levels within the therapeutic level. We use cookies on our website to give you the most relevant experience by remembering your preferences and repeat visits. The EKG results are upsetting Vent rate 80 normal sinus rhythm Pr interval 116ms right atrial enlargement Qrs duration 88 ms minimal voltage requirement for LVH, may be normal variant Qt/qtc 336/387ms st abnormality, possible digitalis effect prt 76. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. Supraventricular tachycardia (SVT), rate 214/min, followed by one sinus-originated complex and a short run of aberrantly conducted SVT (left bundle branch block pattern) Show Less. Necessary cookies are absolutely essential for the website to function properly. } ER said I'm OK. } Im 32 female. Ischemia affects the plateau phase (phase 2) and the rapid repolarization phase (phase 3), which is why ischemia causes changes to the ST segment and T-wave (ST-T changes). MedHelp is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. What causes ST and T wave abnormality? I do not believe that is correct. what does this mean for me @ 73 yrs. The possibility of any problem may be due digitalis which is a powerful cardiac stimulant. Thank you. Share this conversation. Also, mention any symptoms that you are having either at rest or with exertion. It can be depressed by ischemia low potassium depressed and rounded in WebPress J to jump to the feed. BER is a normal variant commonly seen in young, healthy patients. SAD - ST abnormality, probably digitalis NSD - Nonspecific ST depression, could be normal MSDS - Marked T depression, possible septal subendocardial injury . The changes may be seen in all or most of the leads (diffuse changes), or they may be present contiguous leads, such as the inferior, lateral, or anterior leads. Ecg says sinus rhythm, widespread ST-T abnormality - what does this mean?? Show More. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. Factors affecting the ST-T and U wave configuration include: Intrinsic myocardial disease (e.g., myocarditis, ischemia, infarction, infiltrative or myopathic processes) Drugs (e.g., digoxin, quinidine, tricyclics, and many others) Electrolyte abnormalities of potassium, magnesium, calcium. I was going through some old personal papers recently and came across this ER discharge sheet going back to 2011 when I was officially diagnosed with afib - the sheet included a couple of ECG printouts, a chadsvasc 0 score and the and in a Ekg impression normal sinus rhythm But it is not giving any problems & will not require any medical or surgical intervention unless there is some severe infection. nonspecific st abnormality It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. Hypomagnesemia reduces the activity of membrane Na + ,K + -ATPase and may increase kaliuresis and cause hypokalemia. Therefore, digoxin side effects can be avoided by keeping blood levels within the therapeutic level. ), Metabolic factors (e.g., hypoglycemia, hyperventilation), Atrial repolarization (e.g., at fast heart rates the atrial T wave may pull down the beginning of the ST segment), Ventricular conduction abnormalities and rhythms originating in the ventricles, ST-T changes seen in bundle branch blocks (generally the ST-T polarity is opposite to the major or terminal deflection of the QRS), ST-T changes in PVCs, ventricular arrhythmias, and ventricular paced beats, Drug effects (e.g., digoxin, quinidine, etc), Electrolyte abnormalities (e.g., hypokalemia), Neurogenic effects (e.g., subarrachnoid hemorrhage causing long QT), Acute transmural injury - as in this acute anterior MI, Persistent ST elevation after acute MI suggests ventricular aneurysm, ST elevation may also be seen as a manifestation of Prinzmetal's (variant) angina (coronary artery spasm), ST elevation during exercise testing suggests extremely tight coronary artery stenosis or spasm (transmural ischemia), Concave upwards ST elevation in most leads except aVR, No reciprocal ST segment depression (except in aVR). Takotsubo Cardiomyopathy: A STEMI mimic producing ischaemic chest pain, ECG changes +/- elevated cardiac enzymes with characteristic regional wall motion abnormalities on echocardiography. There is appropriate discordance, with the ST segment and T wave directed opposite to the main vector of the QRS complex. Emergency Physician in Prehospital and Retrieval Medicine in Sydney, Australia.

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