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(Circulation. 2007;116:e519-e520.)
© 2007 American Heart Association, Inc.

Images in Cardiovascular Medicine

ST-Segment Elevations Secondary to Electrical Cardioversion

Qaiser Shafiq, MD; Riyaz Bashir, MD

From the Department of Internal Medicine (Q.S.) and Department of Cardiovascular Diseases (R.B.), University of Toledo Medical Center, Toledo, Ohio.

Correspondence to Riyaz Bashir, MD, FACC, Assistant Professor of Medicine, Department of Cardiovascular Diseases, University of Toledo Medical Center, 3000 Arlington Ave, Toledo, OH 43614. E-mail riyazbashir{at}hotmail.com

A 56-year-old woman with primary pulmonary hypertension presented with increasing shortness of breath and palpitations. ECG showed right bundle-branch block and slow atrial flutter with 2:1 AV block (Figure 1). In view of the patient’s hypotension and worsening renal function, she was cardioverted into normal sinus rhythm with a 360-J direct current shock. Immediately after the cardioversion, the ECG showed marked ST-segment elevations in the anterolateral leads (Figure 2). At this time, the patient was asymptomatic, and hence, a repeat ECG was performed, which showed complete resolution of the ST-segment elevations (Figure 3). Cardiac enzymes and electrolytes were normal. Transient elevation of the ST segment after electrical cardioversion has been very well reported in the literature, with an incidence as high as 16%. The mechanism of these ST-segment elevations is not clear.

View larger version (62K): [in this window] [in a new window]   Figure 1. ECG showing right bundle-branch block and slow atrial flutter with 2:1 AV block.

View larger version (63K): [in this window] [in a new window]   Figure 2. ECG showing marked ST-segment elevations in the anterolateral leads.

View larger version (63K): [in this window] [in a new window]   Figure 3. ECG showing resolution of the ST-segment elevations compared with the ECG shown in Figure 2.

	Acknowledgments

 
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Issue Highlights
Circulation 2007 116: 2095. [Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Shafiq, Q. Articles by Bashir, R. Search for Related Content PubMed PubMed Citation Articles by Shafiq, Q. Articles by Bashir, R. Related Collections Electrocardiology CPR and emergency cardiac care Related Article