Which ECG signs are typical of non-ST elevation ischemia or NSTEMI?

• A. ST-segment depression and/or T-wave inversion in contiguous leads
• B. ST-segment elevation in contiguous leads
• C. Q waves in abnormal leads
• D. U waves prominent

Answer: (A)

Subendocardial ischemia, which characterizes NSTEMI, shows up on the ECG as ST-segment depression and/or T-wave inversion in leads that look at the same coronary territory. This downward shift of the ST segment plus T-wave changes reflect ischemia confined to the inner layer of the heart wall, not full-thickness (transmural) injury. In contrast, ST-segment elevation indicates transmural injury, i.e., STEMI, which is a different pattern. Q waves typically appear later and signal established necrosis from a prior or evolving infarction, not the acute NSTEMI pattern. Prominent U waves aren’t a hallmark of ischemia either; they’re usually linked to other conditions like electrolyte issues. So the characteristic NSTEMI ECG finding is ST-segment depression with or without T-wave inversion in contiguous leads.