Adult Critical Care Specialty (ACCS) Practice Exam

Post-operatively, Mr. Hart exhibits a 2-3 mm ST segment elevation on his ECG. This finding is indicative of?

1. Myocardial ischemia

2. Myocardial infarction

3. Myocardial injury

4. Normal variant

The correct answer is: Myocardial injury

In the context of post-operative care, a 2-3 mm ST segment elevation on an ECG is indicative of myocardial injury. This elevation can suggest that there has been some degree of damage to the myocardial tissue, which may occur as a result of various stressors during or after surgery, such as inadequate perfusion, inflammation, or direct trauma. Myocardial injury is characterized by changes in cardiac biomarkers and can manifest on the ECG as ST segment elevation or other changes, depending on the severity and nature of the injury. In contrast, myocardial ischemia typically causes ST segment depression or transient ST segment elevation due to demand-supply imbalances of oxygen, and myocardial infarction usually leads to more significant and persistent ST segment elevation or the development of Q waves. Normal variants would not typically cause this degree of ST segment elevation, as normal ECG findings show established patterns without significant alterations. Hence, in this case, the 2-3 mm ST segment elevation aligns with the concept of myocardial injury post-operatively rather than indicating ischemia or an infarction, or being a benign variant.