ACS/STEMI mimics – Structural heart disease

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Ventricular aneurysm ST elevation in antero-septal leads Old Q waves Check old ECG and history of MI
Left ventricular hypertrophy Up-sloping ST elevation in antero-septal leads
Down-sloping ST in lateral leads
LVH voltage criteria  History of CCF or cardiomyopathy
Right ventricular hypertrophy ST depression, T wave inversion antero-septal leads  Chronic lung disease
(‘Cor Pulmonale’)

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