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What is St Elevation?
Written by Medicover Team and Medically Reviewed by Dr Archana Behera , Cardiologist
ST Elevation is a specific change seen on an ECG (electrocardiogram) where the ST segment appears abnormally elevated. It often signals a serious cardiac issue, especially a ST-Elevation Myocardial Infarction (STEMI), a type of heart attack that happens when a major artery is completely blocked.
It means that a section of the heart muscle isn't getting enough blood and oxygen, which can cause permanent damage if not treated right away.
This condition requires urgent medical attention to save the heart muscle and prevent life-threatening complications. However, not all ST elevations indicate a heart attack. Other causes exist and must be carefully ruled out by a medical professional.
What are the Causes of ST Elevation?
While ST elevation is often a warning sign of a heart attack, it's not always caused by one. Several conditions can lead to this ECG change:
- ST-Elevation Myocardial Infarction (STEMI): This is the most common and serious cause of ST elevation. It happens when a coronary artery is completely blocked, cutting off blood supply to part of the heart muscle.
- Pericarditis: Inflammation of the thin sac surrounding the heart (pericardium) can cause widespread ST elevation on an ECG, usually with chest pain that improves when sitting up.
- Early Repolarisation (Benign ST Elevation): A harmless ECG variant, often seen in healthy young people or athletes. It doesn't require treatment.
- Ventricular Aneurysm: After a heart attack, part of the heart wall may become weakened and bulge out. This area can cause persistent ST elevation, even after the initial event.
- Hyperkalemia: High potassium levels in the blood can affect heart function and change the ST segment, sometimes mimicking a heart attack.
- Brugada Syndrome: A rare genetic condition that can cause abnormal ECG patterns, including ST elevation, and increase the risk of sudden cardiac death.
- Left Ventricular Hypertrophy (LVH): Thickening of the heart's left wall (often due to high blood pressure) can sometimes lead to secondary ST changes on ECG.
- Coronary Vasospasm (Prinzmetal's Angina): Temporary spasm of a coronary artery can restrict blood flow and cause transient ST elevation, often occurring at rest.
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Get Second OpinionWhat are the Symptoms of ST Elevation?
When ST elevation is due to a heart attack (STEMI), symptoms often develop suddenly and may include:
- Crushing chest pain or pressure (often behind the breastbone)
- Pain spreading to the arm, jaw, neck, or back
- Shortness of breath, especially at rest
- Cold sweats, clammy skin
- Dizziness, fainting, or feeling lightheaded
- Fatigue, especially in women or older adults
- Nausea or vomiting, often mistaken for indigestion
- Anxiety or panic, including a feeling that something is very wrong
In some cases, symptoms may be subtle, especially in women, people with diabetes, or older adults. But any sudden chest pain should always be taken seriously.
How is ST Elevation Diagnosed?
ST elevation is usually diagnosed through an electrocardiogram (ECG or EKG), which records the heart's electrical activity. To diagnose ST elevation and determine its cause, doctors use a combination of:
Electrocardiogram (ECG or EKG): This is the primary test. ST elevation appears as an upward shift in the ECG tracing, especially in certain leads that point to the heart area affected.
Cardiac Biomarkers (Blood Tests): Tests like Troponin levels help confirm if the heart muscle has been damaged these are usually elevated in heart attacks.
Echocardiogram: An ultrasound of the heart that shows how well it's pumping and if any areas are not contracting properly due to damage.
Coronary Angiography (Cardiac Cath): This imaging test visualises the heart's arteries. It identifies blockages and guides treatment like stent placement.
Other imaging like chest X-rays or CT scans may be used in certain cases to rule out conditions like pericarditis or pulmonary embolism.
What are the Treatment options of ST Elevation (Especially STEMI)?
The main goal is to restore blood flow to the heart muscle as quickly as possible. Treatment depends on the cause, but in the case of STEMI:
Emergency Interventions
- Primary PCI (Percutaneous Coronary Intervention): A catheter-based procedure to open the blocked artery with a balloon and place a stent.
- Thrombolytic (clot-busting) medications: Used when PCI isn't available quickly, ideally within 30 minutes of hospital arrival.
- Aspirin and blood thinners: To reduce clot formation and prevent further blockage.
Additional Medical Management
- Beta-blockers: Reduce the heart's workload and oxygen demand
- ACE inhibitors or ARBs: Protect heart function and lower blood pressure
- Statins: Lower cholesterol and stabilise plaque in arteries
- Oxygen therapy: If oxygen levels are low
- Pain relief: Such as morphine for chest discomfort
When Should You See a Doctor for ST Elevation?
ST elevation on an ECG (electrocardiogram) can be a sign of a heart attack and other serious heart condition. If you have chest pain, pressure in your chest, shortness of breath, sweating, nausea, or pain in your arm, neck, or jaw, go to the emergency room immediately.
These are signs that your heart may not be getting enough blood.
Even if your symptoms are mild or go away, you should still get checked. ST elevation should always be taken seriously quick treatment can save your life and prevent damage to your heart.
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Recovery and Long-Term Outlook
After surviving an ST-elevation heart attack, the focus shifts to healing and prevention:
- Cardiac rehabilitation programs to rebuild strength and confidence
- Lifestyle changes (heart-healthy diet, quitting smoking, regular exercise)
- Regular follow-ups with a cardiologist
- Medication adherence to prevent future heart issues
The earlier ST elevation is treated, the better the outcome. Many people return to normal activities within a few weeks, especially with structured rehab and ongoing care.
Our Experience in Treating ST Elevation
At Medicover Hospitals, we act fast when ST elevation is detected. Our 24/7 emergency teams are trained to recognise signs of cardiac emergencies and immediately begin life-saving procedures like ECG monitoring, clot-busting therapy, and angioplasty.
With the best cardiac care units, experienced cardiologists, and advanced imaging technology, we ensure each patient receives personalised treatment from the moment they arrive to long after they go home. Our mission is to protect your heart, preserve your quality of life, and give you the confidence to move forward.
