A patient came with h/o chronic kidney disease in due to pleuritic chest pain for about 2 days. There were no fever and chills. VS were stable and saturation was at 99% with room air.
Is this patient having an acute MI?
The basic rhyhtm is sinus with STE in V1-V4, peaked T waves in V3 and V4.There weres some PR depressions. There is Brugada pattern.
Cardio service felt probably not ACS because as mentioned CP has been there for 2 days. Labs showed negative troponins (x3), BUN in the 100's, Cr - 15 and elevated K - 6.4
Since patient had CKD hemodialysis was continued. The K went down and the ST changes resolved. So, the ST changes we due to hyperkalemia. This ECG change is Brugada Phenocopy - http://www.brugadaphenocopy.com/about-brugada-phenocopy.html