ACS/STEMI mimics – Conduction Abnormalities

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Conduction abnormalities

Brugada syndrome ST coved elevation septal leads Partial RBBB morphology History of sudden cardiac death in family especially in Asia
Bundle Branch Block (left or right) ST/T changes opposite polarity to QRS vector (‘discordance) QRS widening Any abnormality of ventricular conduction results in abnormal repolarisation pattern
Paced rhythm Similar to Bundle Branch Block Pacing spikes seen
QRS widening
Check patient for pacemaker
Digoxin  Down-sloping ST in lateral leads Atrial fibrillation Review medications

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