Seeing ST elevation on an ECG can make even the calmest med student break into a cold sweat. But spoiler alert: not every elevation is screaming “MI!” Sometimes it’s just the heart being extra… dramatic.
Let’s decode the drama with the mnemonic: ELEVATION — because apparently the ECG loves to spell.
Causes of ST Elevation in ECG Mnemonic
| Letter | Cause | Quick Notes |
|---|---|---|
| E | Electrolytes | Hyperkalemia & hypocalcemia can mess with repolarization. ⚡ |
| L | LBBB | Left Bundle Branch Block mimics infarct patterns. Don’t let it fool you. 🚫❤️ |
| E | Early Repolarization | Common in young, athletic people. ECG says party, not panic. 🏃♂️ |
| V | Ventricular Hypertrophy | Big muscle = big voltage = big ST segments. 💪 |
| A | Aneurysm (ventricular) | Post-MI scars balloon out. ST stays elevated forever — like a bad grudge. 🧱 |
| T | Treatment (Pericardiocentesis) | Occasionally causes ST elevation post-drainage. Relief comes with side effects. 💉 |
| I | Injury (Acute MI, contusion) | The real deal. This is the one you don’t want to miss. 🚨 |
| O | Osborne Waves | Hypothermia throws in a bonus hump with ST elevation. Baby it’s cold inside. 🧊 |
| N | Non-occlusive vasospasm | Transient coronary artery spasm — a.k.a. Prinzmetal angina. The drama queen of chest pain. 🎭 |
🧠 Fast Facts
- ST elevation is NOT always STEMI.
- Always look at clinical context, reciprocal changes, serial ECGs, and maybe just… don’t call the cath lab over Osborne waves. 🙃
Your ECG might be yelling “STEMI!”, but don’t be gaslit by a heart that’s just cold, hypertrophic, or had a bit too much potassium. Stay calm, check the ELEVATION, and let your brain lead before your adrenaline does. 💊🧘
HAPPY LEARNING, folks! 🙂
Signing off,
Dr. Aurangzaib Qambrani
(MBBS, PLAB, MRCP-UK 1)
Sheikh Khalifa Bin Zayed Hospital Quetta
