(Case 6) Digoxin effect— 12-lead ECG demonstrated NSR with diffuse ST segment depression. (Case 6) Digoxin effect— 12-lead ECG demonstrated NSR with diffuse ST segment depression. Repeat ECG revealed no change in the STD; a previous ECG was similar. The ST segment depression on the ECG was felt to result from the digoxin effect. The morphology of the ST segment depression is highly characteristic of the digoxin effect. In this example, the ST segment is depressed in a downsloping manner with a gradually increasing depression and more rapid return of the depressed segment to the baseline. 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.