STAT ECG Diagnoses: a patient transferred for suspected STEMI, what other etiologies could be causing this ST segment elevation?

ECG Weekly Workout with Dr. Amal Mattu


 A 24-year-old male with past medical history of paraplegia from severe multiple sclerosis is transferred from a nursing home for suspected STEMI. Transfer documentation reports a history of pleuritic chest pain, dyspnea, hypotension, tachycardia, and an elevated troponin of 2.85 ng/mL. The following ECG is obtained:

Before watching this week’s video, ask yourself these questions:

  1. What ECG abnormalities do you notice?
  2. What is your differential for the various causes of ST segment elevation?
  3. Would you activate the cath lab?