ST depression

An electrocardiographic abnormality characterized by displacement of the ST segment below the isoelectric baseline, typically ≥0.5-1 mm in two or more contiguous leads.

Causes

• Myocardial ischemia and cardiac causes

  • Acute coronary syndrome (especially subendocardial ischemia)

  • Reciprocal changes during acute myocardial infarction

  • Ventricular hypertrophy

  • Bundle branch block

  • Tachycardia-related ST changes

  • Stress cardiomyopathy (Takotsubo syndrome)

  • Myocarditis

  • Pericardial disease

• Electrolyte abnormalities

  • Hypokalemia

  • Hypomagnesemia

  • Hypocalcemia

  • Hypercalcemia

• Digoxin

• Physiological causes

  • Exercise-induced changes

  • Hyperventilation

• Other causes

  • Pulmonary embolism

  • Severe anemia