St Depression Vs. St Elevation ?

Q: I am an RN collecting preoperative risk data for cardiac cases. One of the items I capture is ST depression >1mm. I only have basic training on EKG interpretation, and must rely on the documentation provided by the cardiologist or other physician who read the EKG. More often than documentation of ST depression, I seem to see documentation of ST elevation in the medical record.

A:According to my understanding, ST depression is an indicator of ongoing cardiac ischemia. I'm curious about the meaning of ST elevation. It seems like this, too, is worrisome for acute MI. ST Elevation indicates myocardial infarction or pericarditis. You should learn to read ECGs yourself, because you will need to standardise your findings. To rely on operative notes is fraught with danger. ST depression can be caused by use of digoxin or electrolyte disturbances, for example. You'll need to have a standard way of incorporating this into your research. ST depression may also occur early in MI or be present in a contralateral lead. ST elevation also may be present in aneurysm and occur to a small amout as a normal variant. I do hope to get more formal training in EKG interpretation, soon.

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