Non-MI Causes of ST Elevation

The ST segment on an ECG represents the interval between ventricular depolarization and ventricular repolarization.

When ST elevation is present, it is most important to rule out cardiac ischemia or a myocardial infarction. Other causes of ST elevation include:

• Coronary Vasospasm (Prinzmetal’s Angina)
• Acute Pericarditis: typically causes diffuse ST elevation associated with PR depression (reciprocal ST depression and PR elevation seen in leads aVR and V1)
  • Benign Early Repolarization: mild ST elevations with tall T waves, mainly in the precordial leads
• Left Bundle Branch Block
• Left Ventricular Hypertrophy (LVH): usually causes ST elevation in leads with deep S waves (V1-V3)
• Ventricular Aneurysm
• Brugada Syndrome: ST elevations and Right Bundle Branch Block in V1-V2
• Raised Intracranial Pressure (ICP): can cause ST elevation or depression

For ECGs showing the conditions above, visit the link in the references.

REFERENCES

1. https://lifeinthefastlane.com/ecg-library/st-segment/