Differential Diagnosis of ST Elevation (Mimics)

Non-ischemic causes of ST elevation: pericarditis, early repolarization, Brugada syndrome, LVH/LBBB, ventricular aneurysm, hypothermia (Osborn waves), and Takotsubo cardiomyopathy.

STEMI & ACS

When to use this protocol

ST elevationChest painRule out STEMIPericarditisBrugada

Not all ST elevation is ischemic. Recognizing non-ischemic causes prevents unnecessary cath lab activation while identifying other critical conditions.

Last reviewed: February 19, 2026by SymptomDx Medical Team

Differential Diagnosis of ST Elevation (Mimics)

Overview

STEMI Mimics Overview

STEMI vs Pericarditis vs Early Repolarization

Pericarditis — 4 Stages

Brugada Syndrome

LVH Criteria & Strain Pattern

Teaching Points

References

Differential Diagnosis of ST Elevation (Mimics)

Overview

STEMI Mimics Overview

STEMI vs Pericarditis vs Early Repolarization

Pericarditis — 4 Stages

Brugada Syndrome

LVH Criteria & Strain Pattern

Teaching Points

References