Differential Diagnosis for ST Elevation in AVR Lead
Single Most Likely Diagnosis
- Pericarditis: ST elevation in AVR is often seen in pericarditis, particularly when there is concomitant PR depression. The pattern of ST elevation can vary but is typically concave upwards.
Other Likely Diagnoses
- Acute Coronary Syndrome (ACS): While ST elevation in AVR is less common in ACS compared to other leads, it can occur, especially in the context of an inferior wall myocardial infarction.
- Left Ventricular Hypertrophy (LVH): LVH can cause repolarization abnormalities, including ST elevation in AVR due to the increased voltage of the QRS complex.
Do Not Miss Diagnoses
- Acute Aortic Dissection: Although less common, acute aortic dissection can cause ST elevation in AVR due to involvement of the coronary arteries or direct injury to the heart. Missing this diagnosis can be fatal.
- Pulmonary Embolism: In rare cases, a large pulmonary embolism can cause ST elevation in AVR, likely due to right ventricular strain.
Rare Diagnoses
- Hypothermia: Severe hypothermia can cause a variety of ECG abnormalities, including ST elevation in AVR.
- Early Repolarization: This benign condition can mimic ST elevation but is typically seen in the precordial leads. However, it can occasionally be observed in AVR.
- Brugada Syndrome: This genetic disorder can cause ST elevation in the right precordial leads, including AVR, due to abnormalities in the sodium channels of the heart.