ST Elevation Imitators

The following are common ST Elevation imitators that often make an ECG look like there is an ST change.

1. Bundle Branch Block (BBB), in which there is a conduction delay in the bundle branches, which causes the ECG to have a prolonged QRS complex greater than 0.10 seconds. This will often lead to the appears of a raised ST segment where the S wave meets the T wave.

2. Left Ventricular Failure (LVF).

3. Ventricular Rythyms often cause the QRS complex to cover much of the ST segment making the appearance of a possible raise in the ST Segment.

4. Pericarditis, will often result in an increased level of ischaemia to the entire heart, and this will result in a mild to severe ST Segment changes to all ECG leads.

5. Pericardial Tamponade, like pericarditis, results in the myocardium being squeezed by the pericardial sack, and this will result in ischaemia to the entire heart and subsequent ST changes.

6. Certain medications can causes changes to the ST segment of the ECG.

7. A Ventricular Aneurysm may result in a variety of ST changes, both elevation or depression.

8. Benign Early Repolorization, results in the ST segment of the ECG being taken over by the R wave and consequently appears like ST elevation.

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