A straightened ST segment lacks the usual concave shape in leads V2-V6. It can be a subtle sign of coronary occlusion.
See also: ST segment
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This ECG is from a man in his 40s who presented with chest discomfort and diaphoresis since waking a few hours earlier, on a background of prior infarction with PCI years ago, active smoking, high cholesterol and hypertension. This was the repeat ECG on day 2, after pain returned with nausea and diaphoresis that was exactly like his initial pain and did not resolve with morphine.