Picklehaube sign – A sinister electrocardiogram presentation, in a case of multiple myeloma with electrolyte imbalance

ST elevation is most commonly associated with ST elevated myocardial infarction, but there are various other conditions which can cause ST elevation such as pericarditis, Takotsubo cardiomyopathy, J wave syndromes such as Brugada and early repolarization syndrome, left bundle branch blocks, left ventricular hypertrophy, electrolyte imbalance such as hyperkalemia, hypercalcemia, and other nonischemic causes. Hence, all ST elevation should not be treated aggressively instead a detail history and clinical examination should be carried out and other causes of ST elevation should be ruled out before treating it as acute coronary syndrome.