Electrocardiogram pearl: ST-T changes in patient with chest pain – Ischemia or infarction?

Abstract

Most common electrocardiogram (ECG) findings of myocardial ischemia are ST segment deviations & T wave (ST-T) alterations. However, multiple other conditions can cause ST-T changes mimicking ischemia including ventricular hypertrophy, bundle branch block, electrolyte imbalance, drugs, channelopathies, etc. Uncommonly, incorrect placement of limb leads can also produce ST-T changes leading to diagnostic dilemma. We report a case of erroneous limb-lead placement in a 45 years male mimicking ischemic ECG changes.

Keywords

• Ischemia
• limb lead reversal
• ST-T changes