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ST segment depression and T-wave changes may be seen in patients with unstable angina; Depressed but upsloping ST segment generally rules out ischemia as a cause. Also, it can be a normal variant or artifacts, such as: Pseudo-ST-depression, which is a wandering baseline due to poor skin contact of the electrode [3]
Other ECG changes associate with myocardial ischaemia are: ST segment depression with an upright T wave; ST segment depression with biphasic T wave or inverted T wave with negative QRS complex; [5] T wave symmetrically inverted with a pointed apex, while the ST segment is either bowed upwards or horizontally depressed, or not deviated; and ST ...
Schematic representation of normal ECG. In electrocardiography, the ST segment connects the QRS complex and the T wave and has a duration of 0.005 to 0.150 sec (5 to 150 ms). It starts at the J point (junction between the QRS complex and ST segment) and ends at the beginning of the T wave.
An upsloping, convex ST segment is highly predictive of a myocardial infarction (Pardee sign) while a concave ST elevation is less suggestive and can be found in other non-ischaemic causes. [1] Following infarction, ventricular aneurysm can develop, which leads to persistent ST elevation, loss of S wave, and T wave inversion. [1]
Diagnosis is based on an ECG showing ST-segment depression at the J-point of 1 to 3 mm in leads V1 to V6, with tall and symmetrical T waves. [1] The ST-segment is upsloping and there is also often ST-segment elevation of 0.5 to 2 mm in lead aVR. [1] [2] The QRS complex is either normal or slightly wide. [1]
In electrocardiography, a strain pattern is a well-recognized marker for the presence of anatomic left ventricular hypertrophy (LVH) in the form of ST depression and T wave inversion on a resting ECG. [1] It is an abnormality of repolarization and it has been associated with an adverse prognosis in a variety heart disease patients. It has been ...
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Under these criteria, an ECG is positive for an AMI in the presence of LBBB if any of the following criteria are present: ST deviation ≥1 mm (0.1 mV) concordant with QRS polarity in any ECG lead, thus including either: ST depression ≥1 mm (0.1 mV) concordant with QRS polarity, in any ECG lead.