Understanding ST equivalents on ECG

Abstract

Acute coronary syndrome (ACS) is a syndrome due to decreased blood flow in the coronary arteries such that part of the heart muscle is unable to function properly or dies. Even though the detection of a rise and/or fall of cTn values with at least one value above the 99th percentile URL is the key in diagnose of ACS, the role of electrocardiogram (ECG) still plays an important role in ACS simply because of its sensitivity and specificity. In clinical practice, ST-Elevation Myocardial infarction (STEMI) is easy for physicians and cardiologists to identify. STEMI is defined by new ST-elevation at the J-point in the absence of left ventricular hypertrophy and bundle branch block with two contiguous leads with cut-point: ≥ 1mm in all leads other than V2-V3 where the following cut-point apply: ≥ 2mm in men ≥ 40 years; ≥2.5mm in men < 40 years, or ≥ 1.5mm in women regardless of age.