High-risk NSTE-ACS is characterized by which electrocardiographic finding?

High-risk NSTE-ACS is characterized by which electrocardiographic finding?

• A. Ischemic ST-segment depression of 0.5 mm or greater or dynamic T-wave inversion with pain.
• B. ST-segment elevation in multiple leads.
• C. Normal ECG with no ischemic changes.
• D. U waves in several leads.

Answer: (A)

In high‑risk non–ST elevation ACS, the ECG shows ischemic changes without ST‑segment elevation. The hallmark finding is ischemic ST‑segment depression of 0.5 mm or greater in two contiguous leads, or dynamic T‑wave inversion that occurs with chest pain. This pattern signals subendocardial ischemia from an acute coronary process and points to NSTEMI or unstable angina, guiding urgent risk stratification and management. By contrast, ST‑segment elevation in multiple leads would indicate STEMI, not NSTE‑ACS. A normal ECG with no ischemic changes does not reflect the high‑risk ischemia, and U waves are not typical indicators of acute coronary syndromes.

In high‑risk non–ST elevation ACS, the ECG shows ischemic changes without ST‑segment elevation. The hallmark finding is ischemic ST‑segment depression of 0.5 mm or greater in two contiguous leads, or dynamic T‑wave inversion that occurs with chest pain. This pattern signals subendocardial ischemia from an acute coronary process and points to NSTEMI or unstable angina, guiding urgent risk stratification and management. By contrast, ST‑segment elevation in multiple leads would indicate STEMI, not NSTE‑ACS. A normal ECG with no ischemic changes does not reflect the high‑risk ischemia, and U waves are not typical indicators of acute coronary syndromes.