Excessive discordant ST depression.

Excessive discordant ST depression is ST depression with a positive and wide QRS complex. If the depression is > 30% of the R wave height in the presence of a LBBB, it suggests coronary occlusion with a sensitivity of 100% and specificity of 88%.

See also: ST segment

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In the ECGquest archives, this ECG has been tagged with: - Chest pain Dyspnoea Regular Tachycardia Wandering baseline Excessive discordant ST depression. Excessive discordant ST elevation Pacemaker spikes Wide QRS Ventricular pacemaker Multi-vessel disease 12-Lead Dr Pendell Meyers Dr Smith's ECG Blog CC BY-NC
Can you see through this wide complex rhythm?

This ECG is from a man in his 70s who presented with intermittent dyspnoea and chest pain over the past 2 weeks. He had a history of a pacemaker, heart failure, aortic stenosis, diabetes, hypertension, stroke, ischemic heart disease, chronic kidney disease and peripheral vascular disease. This was his initial ECG.

This ECG shows a wide complex tachycardia with ventricular pacing. The excessively discordant ST changes in V4-6 and aVR suggested diffuse subendocardial ischemia. He was found to have severe three vessel disease and a proximal left circumflex stenosis was stented.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Dyspnoea Left Axis Deviation Regular Tachycardia Excessive discordant ST depression. Excessive discordant ST elevation R in aVR Wide QRS Ventricular tachycardia Acute Lateral MI Acute Posterior MI 12-Lead Dr Pendell Meyers Dr Smith's ECG Blog Dr Ken Grauer Dr Stephen W. Smith CC BY-NC
Posterolateral OMI resulting in VT, then R-on-T phenomenon and VF – repeat after sudden worsening of shortness of breath.

This ECG is from a man in his 50s who presented with 1 hour of chest pain and shortness of breath. This was his second ECG after he suddenly became more short of breath.

In the ECGquest archives, this ECG has been tagged with: - Cardiac arrest Chest pain Concordant ST elevation Excessive discordant ST depression. LBBB Acute Inferior MI Positive Sgarbossa criteria 12-Lead Dr Smith's ECG Blog CC BY-NC
Some Cardiologists still are not familiar with Sgarbossa Criteria….. Repeat ECG Post Resuscitation

This ECG is from a man in his 40s who presented with 20 min of chest pain. This ECG was recorded just after he had a VF arrest and was resuscitated.

This ECG shows LBBB with concordant ST elevation in III and aVF with reciprocal depression in aVL. The cause was a 100% acute RCA occlusion.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Dyspnoea Normal Axis Cabrera's sign Concordant ST depression in V1-V3 Excessive discordant ST depression. Fragmented QRS Wide QRS LBBB 12-Lead Serial 12-lead Dr Smith's ECG Blog CC BY-NC
CHF Exacerbation with Old LBBB: Is There New Infarction or Not?

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.