Cardiovascular Medicine Book

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ST ElevationAka: ST-Segment Elevation

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  1. Measurement
    1. Measure at 0.04 sec (1 mm) after the J-Point
    2. Compare to baseline (line drawn from P start to T end)
  2. Causes
    1. Acute Myocardial Infarction
      1. SEE EKG changes in acute MI
    2. Pericarditis
      1. Diffuse ST elevation
    3. Left Bundle Branch Block
      1. Findings
        1. Left Bundle Branch Block in lead V1
        2. QRS Duration > 120 ms
        3. QRS Complex negative (down) in V1
      2. Left ventricular activation delay
        1. Hides ST segment elevation
        2. Evaluate new LBBB as Acute Coronary Syndrome
    4. Pacemaker with paced beats from right ventricle
      1. Left Bundle Branch Block in V1 with pacer spike
      2. Not possible to diagnose Acute MI
    5. Left Ventricular Hypertrophy
      1. Increased QRS Complex amplitude
      2. ST segment elevation/depression in precordial leads
      3. T Wave direction opposite to QRS Complex
      4. Not possible to diagnose Acute MI
    6. Early Repolarization
      1. ST elevation in lateral leads (V5, V6, I, aVL)
        1. Elevation is coved/concave
      2. More common in black men, young and in good health

ST segment elevation (C0520886)

Definition (NCI)EKG ST segment elevation is usually attributed to impending infarction, but can also be due to pericarditis or vasospastic (variant) angina and early repolarization. In some healthy young adults, a form of ST elevation can be normal. The height of the ST segment is measured at a point 2 boxes after the end of the QRS complex. ST segment elevation is considered significant if it exceeds 1 mm in a limb lead or 2 mm in a precordial lead.
Definition (NCI)Evaluation of the interval from the end of ventricular depolarization to the onset of the T wave; it is usually isoelectric in normal subjects.
ConceptsFinding (T033)
EnglishECG ST ELEVATION, EKG ST Segment Elevation, ST ELEVATED, ST elevation, ST SEGMENT ELEVATED, ST Segment Elevation
Spanishsobreelevacion del segmento ST, supradesnivel del intervalo S-T, supradesnivel del ST
Parent ConceptsCoronary Arteriosclerosis (C0010054), Abnormal cardiac conduction (C0232219), EKG finding (C0438154), EKG ST segment changes (C0232326), ST segment (C0429029), Duplicate concept (C1274013)
SourcesCST, DXP, NCI, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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