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Q. What is ST Elevation?
Although a stable LV aneurysm may manifest ST-segment elevation in the precordial leads at rest. Some subjects with normal hearts show a degree of elevation in the anterior precordial leads and also frontal leads. These phenomena, termed early repolarisation is most commonly seen in young black men but is by no means limited to this group (Grucins syndrome). It is found to be very common in well conditioned athletes. If this type of ST-segment elevation returns to normal during exercise, it is usually associated with a normal heart. When measuring for significant ST depression in these patients the resting ST level is not used as baseline, as in those with normal ST-segments. Any exercise induced ST depression seen should be analyzed as if the resting ST were isoelectric. It has also been compared with the Brugada syndrome, where a similar pattern indicated the likelihood of severe, sometimes lethal arrhythmias.
Ed Rivers, a 3rd year medical student, was alone in the hospital ER one night. It was unusually quiet that night, and the resident was getting some much needed sleep. A patient, Mr
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