ST Segment DepressionCreated OnApril 21, 2020Last Updated OnOctober 28, 2020byadmin You are here: Main ECG ST Segment Depression < All Topics Table of Contents ST depression is defined by: a horizontal or down-sloping ST-segment and ≥0.05 mV below the baseline (TP segment) The strongest correlation with ischemia: a down sloping or horizontal ST-segment depression. Upsloping ST-segment depression has a weaker correlation (as it can be seen in sinus tachycardia) Non-ST-elevation acute coronary syndrome (NSTEACS) encompasses two main entities: Non-ST-elevation myocardial infarction (NSTEMI). Unstable angina pectoris (UAP). Both produce the same spectrum of ECG changes and symptoms and are managed identically in the Emergency Department Differential for ST-segment depression in anteroseptal leads Posterior STEMI Mirror image of septal STEMI in leads V1-V3 Large R waves (instead of Q waves) ST-depression (instead of ST-elevation) Upright T waves in V1-V3(instead of inversions) Anteroseptal ischemia Miscellaneous RBBB Hypokalaemia, etc. Take home Point: ST-depression in the anteroseptal leads might represent posterior STEMI. Get posterior leads ECG! *We do not own this ECG, it’s for knowledge sharing purpose
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