What is Upsloping ST depression?

As a medical professional with expertise in cardiology, I can provide you with an explanation of "upsloping ST depression." Upsloping ST depression refers to a specific pattern seen on an electrocardiogram (ECG) during exercise stress testing. The ST segment is a part of the ECG that represents the period between the end of the QRS complex (which signifies the ventricles depolarizing) and the start of the T wave (which signifies the ventricles repolarizing). Normally, the ST segment is relatively flat or has a slight downward slope. However, in some cases, it may show an upward slope, which can be either upsloping or downsloping. Upsloping ST depression is when the ST segment is depressed (below the isoelectric line) and has an upward slope. This pattern is not typically associated with acute ischemia (a lack of blood flow to the heart muscle), which is often indicated by a horizontal or downsloping ST depression. Instead, upsloping ST depression is often considered a nonspecific finding and can be seen in various conditions, including but not limited to: 1. Normal variants in healthy individuals. 2. Conditions that affect the heart's electrical activity, such as electrolyte imbalances. 3. Certain medications that can alter the ECG appearance. It's important to note that the interpretation of ST segment changes on an ECG must be done in the context of the patient's clinical presentation and other diagnostic information. The incidence and significance of ischemia in patients with slow upsloping ST depression during exercise can vary, and modern imaging techniques like SPECT (single-photon emission computed tomography) can help determine the presence and severity of coronary artery disease (CAD).

AIM: We used modern single-photon emission computed tomography (SPECT) imaging protocols to determine the incidence of ischemia in patients with slow upsloping ST depression during exercise and whether this response signifies more or less severe coronary artery disease (CAD) and risk in comparison with rapid upsloping ...