ECG changes in angina

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The ECG is usually normal between attacks. During an attack there may be a transient ST segment depression, symmetrical T wave inversion or tall, pointed, upright T wave may appear.

If the angina is provoked by exertion, an exercise stress ECG should be performed. Myocardial ischaemia is suggested by an ST segment depression greater than or equal to 1 mm. Note that ST elevation may occur in Prinzmetal's angina.

Exercise ECG testing may reveal exercise-induced myocardial ischaemia.

Exercise ECG is abnormal in 85% of patients with angina.

Last reviewed 01/2018