Esophageal Rupture Presenting with ST Segment Elevation and Junctional Rhythm Mimicking Acute Myocardial Infarction

Figure 1

(a) Baseline ECG notable for 1^st degree AV block and poor R wave progression that was comparable to the patient’s prior ECGs. (b) ECG on hospital day 2 showing the interval development of a junctional rhythm along with minor ST segment elevation in leads I, II, and aVL. (c) ECG 36 hours after admission showing persistence of the junctional rhythm along with ST segment elevation in leads I, II, III, aVL, aVF, and V6 along with ST segment depression in leads V1 and V2. This ECG prompted a code STEMI to be activated. (d) ECG after recovery showing a return to normal sinus rhythm with persistence of the 1^st degree AV block and a return of the ST segments to their original baseline.