ST-Segment Elevation: One Sign, Many Shadows

Marco Bergonti; Johan Saenen; Hein Heidbuchel; Andrea Sarkozy

doi:10.1016/j.jaccas.2021.05.023

ST-Segment Elevation: One Sign, Many Shadows

JACC Case Rep. 2021 Sep 1;3(11):1360-1362. doi: 10.1016/j.jaccas.2021.05.023.

Authors

Marco Bergonti^{1

2}, Johan Saenen², Hein Heidbuchel^{2

3}, Andrea Sarkozy^{2

3}

Affiliations

¹ University of Milan, Cardiovascular Disease Fellowship Program, Milan, Italy.
² Department of Cardiology, University Hospital Antwerp, Edegem, Belgium.
³ Cardiovascular Research, University of Antwerp, Antwerp, Belgium.

Abstract

ST-segment elevation in patients sedated with propofol may be a sign of imminent malignant arrhythmias. Although propofol infusion syndrome-electrocardiographic abnormalities are usually described as Brugada-pattern, in unique cases nearly ubiquitous and extensive J-point and ST-segment elevation may be observed. These patients should undergo an ajmaline test following recovery. (Level of Difficulty: Beginner.).

Keywords: Brugada pattern; ECG; ECG, electrocardiogram; J-wave; PRIS, propofol infusion syndrome; ST-segment elevation; STEMI, ST-segment elevation myocardial infarction; shark fin pattern.