Common ECG Findings in Patients with Myocardial Ischemia

Patients suffering from myocardial ischemia often display specific changes on an electrocardiogram (ECG). In clinical practice, the ECG remains one of the primary tools used to diagnose the presence of myocardial ischemia. This diagnostic method is not only cost-effective but also easy to perform, making it a popular choice among healthcare professionals.

T Wave Abnormalities and Their Significance

One of the most common ECG indicators of myocardial ischemia is the appearance of a flattened T wave or symmetric T wave inversion. A flattened T wave is defined as having an amplitude less than one-tenth of the corresponding R wave height in the same lead, particularly in leads where the R wave is dominant. Symmetric T wave inversions are considered more clinically significant and are often indicative of myocardial ischemia, which may be caused by underlying coronary artery disease.

Differentiating Between Symmetric and Asymmetric Inversions

Asymmetric T Wave Changes

In contrast, asymmetric T wave inversions may suggest myocardial damage due to other conditions, such as hypertension. These variations are crucial for clinicians to evaluate, as they help distinguish between ischemic heart disease and other cardiac pathologies.

ST Segment Alterations in Myocardial Ischemia

Another key ECG finding in ischemic heart disease is ST segment depression, which can appear either as a horizontal or downsloping pattern. Of these, horizontal ST depression is considered more clinically relevant, often indicating a more severe degree of myocardial ischemia. In certain cases, when the ST segment is elevated in a convex upward manner, this may signal variant angina or even acute myocardial infarction—both of which are serious manifestations of myocardial ischemia.