Spurious ST Segment Elevation

Report:

Sinus bradycardia 43/min

Left atrial abnormality

First degree AV block

Escape-capture bigeminy

Third degree AV block (mid-second strip onward)

Junctional rhythm 64/min

Comment:

The broad shallow sinus P waves, with their first degree AV block, were superimposed on the slightly elevated ST segments of the escape beats and virtually invisible during the bigeminy. Since then, another case report described ST segment elevation due to first degree AV block88.

The ninth cycle in the second strip is longer than the subsequent junctional cycles: the junctional focus seems to have realised it’s on its own from now on!

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