Skip to main content
ECG library

Lateral ST depression: subendocardial ischemia

core

A 79-year-old with sepsis, a hemoglobin of 68, and new chest tightness.

25 mm/s · 10 mm/mV · synthetic tracing
100%
IIIIIIaVRaVLaVFV1V2V3V4V5V6
II (rhythm)
Calipers:2000 ms50.0 small boxes30 bpm if R-RDrag the orange markers. One small box = 40 ms.

Key findings

  • Widespread horizontal ST depression
  • No territorial elevation
  • A stressed physiology at the bedside

Learning points

  • Depression in many territories usually means demand ischemia: treat the fever, the anemia, the tachycardia.
  • Depression maximal in V1 to V3 is the exception: think posterior infarction and look at the mirror.

Connected