Concordant ST depression in V1-3 occurs when there is a negative QRS with ST depression. This is part of the Sgarbossa criteria for diagnosing infarction in the presence of a bundle branch block.
See also: ST segment
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This ECG is from an elderly woman who presented with chest pain on a background of a normal angiogram 3 months prior.
This ECG shows ventricular paced rhythm (likely biventricular) with concordant ST depression in III, aVF and V3. There is excessive discordant ST elevation in I and aVL. The cause was an acute left main occlusion due to suspected embolism.
This ECG is from a female in her 60s presented with 2-3 days of fatigue and shortness of breath. She called EMS when her symptoms acutely worsened while she was shopping. EMS arrived and recorded a heart rate of 27. On arrival to the ED she was noted to be in complete heart block. She was given atropine with transient increase in HR to 80s. This ECG was recorded after atropine.
This ECG shows sinus rhythm with second degree type 1 AV block and LBBB. Concordant ST elevation in III and aVF and concordant ST depression in V2. The cause was an occluded proximal right coronary artery. This was missed and the patient died.
This ECG is from a woman in her 60s who presented with chest pain, nausea, vomiting and diarrhoea for 4 hours.
This ECG shows complete heart block with most likely junctional escape and LBBB. Excessive discordant ST elevation in inferior leads and concordant ST depression in V2. The cause was an acute inferior MI.
This ECG is from a man in his 70s with severe dilated cardiomyopathy who presented with worsening peripheral oedema, anorexia and weakness. There was no chest pain or acute dyspnoea.
This ECG shows A-V sequential pacing with appropriate discordant ST segments apart from concordant ST depression in V3. This was not dynamic and there was no further evidence of infarction. He was most likely just generally deconditioned due to his cardiomyopathy and needed medication review.
This ECG is from a very elderly woman who presented with shortness of breath, chest and back pain intermittently for several nights. It was relieved by isosorbide, but when she lost this medication she became worse. She had a background of CAD, ischemic cardiomyopathy and heart failure with an ICD in situ for primary prevention. On arrival she was hypoxic (SpO2 88%) with a good BP and HR 90, but improved on CPAP then BIPAP. This was her initial ECG.