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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- Rowlands, A and Sargent, A (2019) - The ECG Workbook, 4th edn, M&K Publishing
- Thaler, MS (2018) - The Only EKG Book You'll Ever Need, 9th edn, Lippincott Williams and Wilkins
- (2015) - ECG Interpretation Made Incredibly Easy!, 6th edn, Lippincott Williams & Wilkins
- Houghton, AR and Gray, D (2014) - Making Sense of the ECG: A Hands-on Guide, 4th edn, Taylor and Francis
- Goldberger, A (2006) - Clinical Electrocardiography: A Simplified Approach, 9th edn, Elsevier
- Strong Medicine (2014) - Intro to EKG Interpretation - Myocardial Infarctions (Part 1 of 2), (Accessed: 05/09/2019)
- Strong Medicine - Intro to EKG Interpretation - Myocardial Infarctions (Part 2 of 2), (Accessed: 05/09/2019)
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.
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.
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.