ECG tutorial: ST and T wave changes

INTRODUCTION

ST and T wave changes may represent cardiac pathology or be a normal variant. Interpretation of the findings, therefore, depends on the clinical context and presence of similar findings on prior electrocardiograms.

NONSPECIFIC ST-T WAVE CHANGES

Nonspecific ST-T wave changes are very common and may be seen in any lead of the electrocardiogram. The changes may be seen in all or most of the leads (diffuse changes), or they may be present contiguous leads, such as the inferior, lateral, or anterior leads.

The types of abnormalities are varied and include subtle straightening of the ST segment, actual ST segment depression or elevation, flattening of the T wave, biphasic T waves, or T wave inversion (waveform 1). In the absence of a clinical history or symptoms, T wave abnormalities and flattened and depressed ST segment changes are nonspecific. Causes of these changes include:

Functional and physiologic variants (eg, post-prandial)

Electrolyte abnormalities

               

Subscribers log in here

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:
Literature review current through: Aug 2014. | This topic last updated: Jun 25, 2014.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2014 UpToDate, Inc.