How is ST elevation defined in terms of lead displacement?

• A. Elevation of the ST segment by 1 mm or more in at least 2 contiguous leads
• B. Elevation of the ST segment by 0.5 mm or less in any lead
• C. Elevation of the PR interval in two leads
• D. Elevation of the T wave without changes in the ST segment

Answer: (A)

ST elevation is a critical finding on an ECG, particularly in the context of diagnosing conditions like myocardial infarction. The definition of ST elevation specifically identifies a rise in the ST segment by 1 mm or more above the baseline in at least two contiguous leads. This is important because it provides a clear and standardized criterion for identifying significant ischemic changes in the heart.

The requirement for the elevation to occur in at least two contiguous leads is based on the anatomy of the heart; it helps to confirm that the elevation is not a coincidental finding but rather indicative of a broader area of myocardial injury. The concept of "contiguous leads" refers to leads that view the same area of the heart, which allows for a more reliable assessment of changes associated with acute coronary syndromes.

In contrast, other criteria mentioned in the alternative options do not accurately describe ST elevation or are not relevant to identifying significant changes in the ST segment. For example, an elevation of 0.5 mm or less is not clinically significant and does not meet the standard for diagnosis. Elevation of the PR interval or T wave changes also are unrelated to the definition of ST segment elevation, thus reinforcing the importance of the specific threshold and the requirement for contiguous leads.