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. 2021 Jul-Aug;21(4):257-259.
doi: 10.1016/j.ipej.2021.03.003. Epub 2021 Apr 3.

Challenging ST elevation during night shift

Stefano Cornara  1 , Matteo Astuti  2 , Luca Bacino  2 , Alberto Somaschini  2 , Francesco Pentimalli  2
Affiliations

Challenging ST elevation during night shift

Stefano Cornara et al. Indian Pacing Electrophysiol J. 2021 Jul-Aug.

Abstract

  1. •

    Every ST segment elevation is suspicious of acute myocardial infarction and the diagnosis should be reached in a short time.

  2. •

    Electrolyte imbalance (i.e. hyperkaliemia) and Ph alterations should always be considered.

  3. •

    The treatment of electrolyte imbalance should be performed promptly, even before considering interventional treatments.

  4. •

    Brugada syndrome should be considered as a diagnosis, especially in patients with syncope and a coved type ST elevation in the right precordial leads.

  5. •

    Even a diagnostic type 1 Brugada pattern could be a phenocopy due to electrolyte imbalance.

  6. •

    When Brugada syndrome is presumed and electrolyte imbalance is present, an Ajmaline test is required to confirm the diagnosis.

Keywords: Brugada syndrome; Electrolyte imbalance; STEMI; St elevation.

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Conflict of interest statement

Declaration of competing interest All authors have no disclosure.

Figures

Fig. 1
Fig. 1
The first ECG received during night shift.
Fig. 2
Fig. 2
ECG recorder after 50 min of treatment.
See this image and copyright information in PMC

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