The various causes of electrocardiographic ST segment depression. The various causes of electrocardiographic ST segment depression. (A) ST segment depression related to non-infarction ischaemia, horizontal in morphology. (B) Reciprocal ST segment depression in lead III in a patient with acute anterior wall AMI. (C) Lead V2 STD attributable to posterior wall AMI. (D) Digoxin effect. (E) Left ventricular hypertrophy. (F) Left bundle branch block. T Pollehn et al. Emerg Med J 2002;19:129-135 Copyright © BMJ Publishing Group Ltd and the College of Emergency Medicine. All rights reserved.