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Professional Technical IVT

tombstoning

Extreme ST-segment elevation resembling a tombstone shape, indicating massive myocardial infarction.

Full Definition

Tombstoning is an electrocardiographic pattern characterized by extreme ST-segment elevation that merges with tall, upright T waves, creating a monophasic morphology resembling the shape of a tombstone. This pattern typically indicates massive transmural myocardial infarction with complete coronary occlusion and extensive myocardial damage. Tombstoning is most commonly seen in acute anterior STEMI due to proximal left anterior descending artery occlusion and carries a poor prognosis with high mortality risk. The term reflects both the ECG appearance and the grave clinical implications.

Usage

Usage note: Informal but widely recognized term; indicates need for urgent intervention.

In Context

  • "The ECG demonstrated tombstoning in leads V1-V6 consistent with massive anterior STEMI." — Emergency cardiology consultation
  • "Tombstoning pattern predicted extensive myocardial damage and cardiogenic shock development." — Cardiology progress note

Also known as

tombstone pattern

Don't confuse with

peaked T waves hyperacute T waves

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