The Differential Between ST Elevation and ST Depression in ECGs From Patients With Ischemic Symptoms

ECGs with secondary ST changes can develop superimposed ischemia. If left bondar branch block produces distorted ST changes, look for concordant ST elevation in anterior leads. Sub-indocardial ischemia may result in diffuse ST depression with ST elevation in AVR. But AVR does not correspond to any vascular territory. The differential for this pattern includes anything that severely disrupts the supply-demand balance including acute coronary occlusion and sepsis.