ST segment depression in myocardial ischemia and differential diagnoses

ST segment depression in myocardial ischemia and differential diagnoses

ST segment depression due to acute myocardial ischemia ST segment depressions caused by ischemia are characterized by a horizontal or downsloping ST segment. Indeed, North American and European guidelines assert that the ST segment must be either downsloping or horizontal. Otherwise, ischemia is unlikely to be the cause of the ST segment depression. The horizontal ST segment depression is more specific than the downsloping depression. Refer to  Figure 1 . Figure 1. Characteristics of ischemic ST segment depressions on  ECG . Current guideline criteria for ischemic ST segment depression: New horizontal or downsloping ST segment depressions ≥0,5 mm in at least two anatomically contiguous leads. The transition from ST segment to T-wave is more abrupt in ischemia (the transition is normally smooth). Refer to  Figure 2 . Figure 2. Transition from ST segment to T-wave in ischemia. Ischemic ST segment depressions occur in both NSTE-ACS ( NSTEMI  and unstable  angina pectoris ) and  STE-ACS  (STEM). However, th…

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