What causes ST elevation?

As a medical professional with expertise in cardiology, I can explain that ST elevation on an electrocardiogram (ECG) can be caused by a variety of conditions, but it is most commonly associated with acute myocardial infarction (AMI), also known as a heart attack. Here's a detailed explanation: 1. Acute Myocardial Infarction (AMI): The most serious cause of ST elevation is a heart attack, which occurs when the blood supply to a part of the heart muscle is blocked, usually by a blood clot. This blockage can damage or destroy the heart muscle, leading to the characteristic ST elevation on an ECG. 2. Prinzmetal's Angina (Variant Angina): This is a form of angina that can cause ST elevation, especially during rest or at night. It is caused by the spasm of a coronary artery, which can lead to a temporary reduction in blood flow. 3. Left Ventricular Hypertrophy (LVH): In some cases, ST elevation can be seen in patients with LVH, which is an enlargement of the walls of the left ventricle of the heart. 4. Early Repolarization Syndrome: This is a benign condition where the normal electrical activity of the heart is altered, leading to ST elevation. It is often seen in young, healthy individuals and is not associated with heart disease. 5. Brugada Syndrome: A genetic disorder that affects the heart's electrical system, which can present with ST elevation in the right precordial leads of the ECG. 6. Hyperkalemia: High levels of potassium in the blood can lead to changes in the ECG, including ST elevation. 7. Pericarditis: Inflammation of the pericardium, the sac-like structure surrounding the heart, can also cause ST elevation. 8. Pulmonary Embolism (PE): A blockage in one of the pulmonary arteries by a clot can lead to changes in the ECG, including ST elevation. 9. Myocarditis: Inflammation of the heart muscle can also result in ST elevation. 10. **Takotsubo Syndrome (Stress Cardiomyopathy)**: This is a condition where severe emotional or physical stress causes a sudden weakening of the heart muscles, which can present with ST elevation. It's important to note that ST elevation is a significant finding and requires immediate medical attention to determine the underlying cause and initiate appropriate treatment.

It represents the interval between ventricular depolarization and repolarization. The most important cause of ST segment abnormality (elevation or depression) is myocardial ischaemia or infarction.