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It is important to recognize that there are several conditions aside from STEMI that cause ST-segment elevation. Here are some of the many possible causes to consider:
Acute myocardial injury (acute coronary occlusion or trauma)
Global ischemia (e.g. s/p epinephrine administration , aortic dissection, massive PE, GI bleeding, etc.)
Early Repolarization
Myo/pericarditis
Vasospasm
Ventricular aneurysm
LBBB/pacemaker
Pulmonary embolism
LVH/high left ventricular voltage (WPW, athlete’s heart, etc.)
Na+ channelopathy (e.g. Brugada syndrome & mimics, TCA’s, etc.)
Post-cardioversion (stunning)
Hyperkalemia
Hypothermia
Takotsubo cardiomyopathy
Intracranial abnormalities
“Spiked Helmet” sign
Hypercalcemia
Check out the following links for specific differentials when dealing with diffuse STE or STE in aVR
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