Reciprocal ST depression

Reciprocal ST depression occurs in the leads that are electrically opposite from those showing ST elevation during an acute infarction. For example, inferior coronary occlusion is associated with reciprocal ST depression in aVL, lateral infarction with III / aVF, and posterior infarction with reciprocal ST depression in V1-3.

See also: ST segment

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References

ECG Library (60)

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In the ECGquest archives, this ECG has been tagged with: - 12-Lead Anterior ST elevation Lateral ST elevation Reciprocal ST depression Acute Anterior MI Dr Smith's ECG Blog CC BY-NC
5 Cardiologists said this is not a STEMI. But was it an OMI?

This ECG is from a man in his 50s who presented with waxing and waning chest pain starting at rest.

This ECG shows ST elevation V1-5, I, II and aVL with reciprocal depression in III. The cause was an anterior MI.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Hyperacute T waves Lateral ST elevation Reciprocal ST depression Acute Anterior MI Dr Smith's ECG Blog CC BY-NC
The ECG was correct. The angiogram was not.

This ECG is from a man in his 70s who presented with chest pain and nausea on a background of previous MI.

This ECG shows sinus rhythm with PVCs and subtle ST elevation in I, aVL and V2 and reciprocal ST depression in III and aVF. Angiogram was negative. The most likely cause was a brief LAD occlusion that spontaneously reperfused.

In the ECGquest archives, this ECG has been tagged with: - Abdominal pain 12-Lead Anterior ST elevation Reciprocal ST depression ST elevation in aVL Acute Anterior MI Dr Smith's ECG Blog CC BY-NC
OMI Confirmed by POCUS Echo in a 50 year man

This ECG is from a man in his 50s who presented with intermittent epigastric burning pain for 4 days that had become constant that morning.

This ECG shows ST elevation in aVL, I and V2-4 with reciprocal ST depression inferiorly. POCUS showed severe hypokinesis of the anterior wall. The cause was a large anterior MI.

In the ECGquest archives, this ECG has been tagged with: - 12-Lead Inferior ST elevation Reciprocal ST depression Acute Inferior MI ECG Interpretation CC-BY-NC-SA
ECG Blog #167 (Reciprocal-OMI-Normal)

This ECG shows inferior ST elevation with Q waves in III and reciprocal ST depression in aVL, most likely caused by an acute inferior MI.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Syncope 12-Lead Inferior ST elevation Reciprocal ST depression Acute Inferior MI Dr Smith's ECG Blog CC BY-NC
2 ECGs texted to me. Minimal STE in inferior leads. How important is it?

This ECG is from a patient of unknown age who presented with a syncopal episode and vague chest pain. This was the second ECG taken 24 min later.

This ECG shows subtle inferior ST elevation with reciprocal ST depression in aVL. The cause was a 100% distal RCA occlusion.

In the ECGquest archives, this ECG has been tagged with: - Abdominal pain Chest pain 12-Lead Reciprocal ST depression ST elevation in aVL Acute Lateral MI Acute Posterior MI Dr Smith's ECG Blog CC BY-NC
Epigastric pain radiating to the chest for 18 hours. ECG makes the Dx. Troponin makes the Dx. CT makes the Dx!

This ECG is from a middle aged man who presented with 18 hours of epigastric pain radiating to the chest.

This ECG shows ST elevation in aVL with reciprocal ST depression in inferior leads and V3-4, consistent with high lateral MI and posterior involvement.

In the ECGquest archives, this ECG has been tagged with: - Dyspnoea 12-Lead Inferior ST elevation Reciprocal ST depression Acute Inferior MI Dr Smith's ECG Blog CC BY-NC
A Patient with Respiratory Failure and a Computer “Normal” ECG

This ECG is from a patient of unknown age who had recurrent presentations for shortness of breath due to asthma.

This ECG shows subtle ST elevation in III with reciprocal change in aVL. The cause was inferior MI.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Incorrect Machine Interpretation Inferior ST elevation Reciprocal ST depression Acute Inferior MI Dr Smith's ECG Blog CC BY-NC
Chest pain resolved, and a “Normal” ED ECG

This ECG is from a middle aged male who presented with chest pain. He was pain free at the time of this initial ECG.

This ECG shows subtle inferior ST elevation with reciprocal change in aVL. The cause was a large inferior infarct.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Inferior ST elevation Reciprocal ST depression Acute Inferior MI EMergucate CC-BY-NC-SA
ECG of the Week – 5th March 2019 – Interpretation

This ECG is from a man in his 50s who presented with left sided chest pain.

This ECG shows ST elevation in inferior leads with reciprocal changes in aVL and I

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Anterior ST depression Inferior ST elevation Reciprocal ST depression Acute Inferior MI Acute Posterior MI Right ventricular MI ECG Guru CC-BY-NC-SA
Instructors’ Collection ECG: Inferior Wall M.I. With Atrial Fibrillation or Atrial Flutter

This ECG is from a man in his 70s who presented with chest pain. He had a history of COPD.

This ECG shows massive inferior ST elevation with widespread ST depression. The most likely cause was an acute inferior infarct.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Inferior ST elevation Peaked T waves Reciprocal ST depression ST elevation in V1 Right ventricular MI Dr Smith's ECG Blog CC BY-NC
The Interventionalist Refuses Angiography, and even to speak to the Emergency Physician – repeat ECG pain free

This ECG is from a middle aged patient who presented with chest pain of uncertain duration. This was the repeat ECG when pain returned.

This ECG shows ST elevation in V1, II, III and aVF with reciprocal ST depression in aVL. The cause was a proximal RCA occlusion. The T waves were peaked but the potassium was normal.

In the ECGquest archives, this ECG has been tagged with: - 12-Lead Inferior ST elevation Pathological Q waves Reciprocal ST depression Acute Inferior MI ECG Interpretation CC-BY-NC-SA
ECG Blog #158 (STEMI – OMI – Ischemia – ST depression – not acute)