ST-segment elevation after direct current shock mimicking acute myocardial infarction: a case report and review of the literature

Am J Emerg Med. 2014 Nov;32(11):1438.e1-3. doi: 10.1016/j.ajem.2014.04.005. Epub 2014 Apr 13.

Abstract

External direct current (DC) shocks are and have long been commonly used for electrical cardioversion/defibrillation of atrial or ventricular arrhythmias. ST-segment elevation after cardio version with DC is an easily ignored phenomenon, occurring acutely and resolving during the first few minutes postshock. Here, we describe electrocardiographic findings of widespread ST-segment elevation lasting at least 1 hour after DC cardioversion for ventricular defibrillation due to Brugada syndrome and mimicking acute myocardial infarction (AMI). This case of ST-segment elevation without a dynamic and evolving AMI underscores the need to consider other causes of ST-segment elevation.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Brugada Syndrome / diagnosis*
  • Brugada Syndrome / physiopathology
  • Brugada Syndrome / therapy*
  • Coronary Angiography
  • Defibrillators, Implantable
  • Diagnosis, Differential
  • Electric Countershock*
  • Electrocardiography
  • Humans
  • Male
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / physiopathology
  • Ventricular Fibrillation / diagnosis*
  • Ventricular Fibrillation / physiopathology
  • Ventricular Fibrillation / therapy*