What changes on ECG may indicate NSTE-ACS?
Changes on ECG in patients with NSTE-ACS include ST depression, transient ST-elevation, or new T-wave inversion. A normal ECG may also be associated with left circumflex or right coronary artery occlusions, which can be electrically silent (in which case posterior electrocardiographic leads [V7 ] may be helpful). Right-sided leads (V3 R to V4 R) are typically performed in the case of inferior STEMI to detect evidence of right ventricular infarction. Left ventricular (LV) hypertrophy, bundle-branch blocks with repolarization abnormalities, and ventricular pacing may mask signs of ischemia/injury.