Action Potential-Like ST Elevation in a Young Patient With No Heart Disease

Tombstone ST elevation in the electrocardiogram (ECG) is an ominous marker of high-risk ST-elevation myocardial infarction (STEMI) but occasionally, it can be caused by severe, non-cardiac conditions. A woman in her early 20s was hospitalized after intentional overdose of ibuprofen. An empty box of ibuprofen was found at the bedside, but it was unknown exactly how many pills the patient had taken. On presentation, she was unresponsive, hypothermic and had severe metabolic acidosis. Alcohol, salicylate and acetaminophen levels were negative.