ST segment elevation in acute myocardial ischemia and differential diagnoses

ST segment elevation in acute myocardial ischemia and differential diagnoses

ST segment elevation in acute myocardial ischemia ST segment elevations with straight (horizontal, upsloping, or downsloping) or convex ST segment strongly suggest acute transmural ischemia ( Figure 1 A ). Concave ST segment elevations, on the other hand, are much less likely to be caused by ischemia ( Figure 1 B ). This is noted in both North American and European guidelines. However, a concave ST segment does not rule out ischemia, it merely reduces the probability of ischemia as the underlying cause. Concave ST segment elevations are actually very common in the population (discussed below). Study  Figure 1  carefully . Figure 1. Types of ST segment elevations on  ECG . Current guideline criteria for ischemic ST segment elevation: New ST segment elevations in at least two anatomically contiguous leads: •  Men age ≥40 years:  ≥2 mm in V2-V3 and ≥1 mm in all other leads. •  Men age <40 years:  ≥2,5 mm in V2-V3 and ≥1 mm in all other leads. •  Women (any age):  ≥1,5 mm in V2-V3 and ≥1 mm in all other lea…

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