Related Experiment Video

Updated: Aug 13, 2026

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

Do we intervene inappropriately for ST elevation?

A Sanders1, A Froude, F Probst

  • 1Emergency Department, Charing Cross Hospital, UK. alisanders@btinternet.com

Emergency Medicine Journal : EMJ
|January 28, 2006
PubMed

Insights

ST elevation on ECGs can indicate acute myocardial infarction (AMI) or pneumothorax. Differentiating these conditions is crucial for timely and appropriate emergency medical treatment.

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Pulmonology

Background:

  • ST elevation on a 12-lead electrocardiogram (ECG) is a key indicator of acute myocardial infarction (AMI).
  • However, ST elevation can also be present in other critical conditions, mimicking cardiac events.
  • Spontaneous pneumothorax is one such condition that can present with ECG changes.

Observation:

  • This report details three cases presenting with chest pain and ST elevation on ECG.
  • All three patients were diagnosed with pneumothoraces.
  • Only one of the three patients had an actual acute myocardial infarction.

Findings:

  • The diagnostic challenge lies in distinguishing between AMI and pneumothorax when both present with ST elevation.
  • Misdiagnosis can lead to inappropriate treatment, such as administering thrombolysis to patients without AMI.
  • One patient in this series received thrombolysis inappropriately due to the initial misinterpretation of ECG findings.

Implications:

  • Emergency physicians must be vigilant in differentiating ST elevation caused by pneumothorax from that caused by AMI.
  • Rapid and accurate diagnosis is essential, especially given the emphasis on "door-to-needle" times for AMI treatment.
  • Considering alternative diagnoses like pneumothorax in patients with chest pain and ST elevation can prevent iatrogenic harm and ensure appropriate care.

More Related Videos

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction05:26

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction

Published on: May 28, 2019

Related Concept Videos

Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
Mitral Stenosis IV: Nursing Management01:27

Mitral Stenosis IV: Nursing Management

A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...