Hyperkalemia mimicking myocardial infarction with ST segment elevation; Brugada phenocopy – case report

Although classical guideline-based ST-segment elevation myocardial infarction diagnostic criteria have a high specificity (97.6%) for diagnosing myocardial infarction with acutely occluded coronary arteries, other clinical states may result in similar ECG abnormalities. Interpretation of those abnormalities is especially challenging in patients with an altered mental state, as it is usually impossible to correlate them with angina symptoms. This can result in unnecessary coronary cath lab activation and patient exposure to invasive procedures with potential complications. We present a rare case of a patient with ST-segment elevation on ECG that was secondary to hyperkalemia in the course of diabetic ketoacidosis.