Chameleons: Electrocardiogram Imitators of ST-Segment Elevation Myocardial Infarction

Jose V Nable; Benjamin J Lawner

doi:10.1016/j.emc.2015.04.004

Chameleons: Electrocardiogram Imitators of ST-Segment Elevation Myocardial Infarction

Emerg Med Clin North Am. 2015 Aug;33(3):529-37. doi: 10.1016/j.emc.2015.04.004. Epub 2015 Jun 4.

Authors

Jose V Nable¹, Benjamin J Lawner²

Affiliations

¹ Department of Emergency Medicine, MedStar Georgetown University Hospital, Georgetown University School of Medicine, 3800 Reservoir Rd NW, G-CCC, Washington, DC 20007, USA. Electronic address: [email protected].
² Department of Emergency Medicine, University of Maryland School of Medicine, 6th floor, Suite 200110 South Pace Street, Baltimore, MD 21201, USA.

PMID: 26226864
DOI: 10.1016/j.emc.2015.04.004

Abstract

The imperative for timely reperfusion therapy for patients presenting with ST-segment elevation myocardial infarction (STEMI) underscores the need for clinicians to have an understanding of how to distinguish patterns of STEMI from its imitators. These imitating diagnoses may confound an evaluation, potentially delaying necessary therapy. Although numerous diagnoses may mimic STEMI, several morphologic clues may allow the physician to determine if the pattern is concerning for either STEMI or a mimicking diagnosis. Furthermore, obtaining a satisfactory history, comparing previous electrocardiograms, and assessing serial tests may provide valuable clues.

Keywords: Electrocardiogram; Electrocardiography; Myocardial infarction; STEMI.

Publication types

Review

MeSH terms

Arrhythmias, Cardiac / diagnosis
Bundle-Branch Block / diagnosis
Diagnosis, Differential
Electrocardiography*
Heart Aneurysm / diagnosis
Humans
Hyperkalemia / diagnosis
Hypertrophy, Left Ventricular / diagnosis
Myocardial Infarction / diagnosis*
Myocardial Infarction / physiopathology
Myocardial Reperfusion Injury / physiopathology
Takotsubo Cardiomyopathy / diagnosis