Modern people are paying more and more attention to health, and many of our friends have to do routine medical checkups every year. However, some people will find that ST-T changes are written on the ECG diagnosis when they have an ECG examination. Some non-cardiologists who look at such an ECG can easily diagnose “myocardial ischemia” and advise patients to take medication! Although it is right to pay attention to the disease, the words “myocardial ischemia” appear too often nowadays, and many people who do not have heart disease have increased their psychological and financial burdens because of these four words. Is the presence of ST-T changes on the electrogram a so-called “myocardial ischemia”? First of all, it should be clear that “myocardial ischemia” is not a standardized disease name, and no diagnostic textbook will use “myocardial ischemia” as a disease name. The term “myocardial ischemia” is also known as coronary atherosclerotic heart disease. This disease refers to the formation of atherosclerotic plaques in the blood vessels supplying the heart, causing narrowing of the lumen and insufficient blood supply when the heart is under increased load, resulting in angina pectoris. ST-T wave changes on the ECG are indeed an important indicator for the diagnosis of coronary heart disease, but they often need to be combined with whether the patient has a family history of heart disease, whether there are concomitant diseases such as hypertension and diabetes, whether there are bad habits such as smoking, and also whether he or she has symptoms such as chest tightness and pain. Therefore, not all ST-T changes are indicative of severe coronary artery disease. If you are young, have no genetic history, have no bad habits, and only have abnormal T waves on the ECG without any symptoms of chest tightness or chest pain, it is generally not a big problem. If you are not sure, you can visit a regular cardiology specialist, and the doctor will advise you to observe the situation or do further tests, such as cardiac ultrasound, coronary CT, etc. Some patients may need to do an ambulatory ECG examination. In many cases, patients with non-coronary artery disease may also have ST-T changes, such as baseline instability on ECG, causing the illusion of ST-T changes. A subset may be related to the presence of medications taken, such as digitalis drugs. In some female patients, there may be a plant nerve disorder, mental depression, and psychological anxiety, which can also increase the occurrence of ST-T changes. Some patients with other cardiac diseases, such as hypertension, left ventricular hypertrophy, and pre-excitation syndrome, also have ST-T changes, but this may not necessarily suggest that he has coronary heart disease. Some neurological diseases can also have ECG changes, such as cerebrovascular accidents, brain tumors, etc. These non-coronary artery diseases cause ST-T changes in ECG, which need to be paid attention to the primary disease, not the coronary artery disease. ST-T changes can also occur in healthy people, and according to statistics, about 10-30% of normal people have ST-segment abnormalities on the ECG, and 15-20% have T-wave changes. They are more common in women, especially in young and middle-aged women. When the abnormal ECG is found in this group of people, it is easy to be labeled as “myocardial ischemia”, which makes them anxious and even take medication for a long time, which is extremely unnecessary. When you are found to have ST-T changes in the ECG, but do not have any symptoms of chest pain, do not easily diagnose yourself with “myocardial ischemia”, we recommend that you go to a regular hospital cardiovascular medicine specialist to listen to the doctor’s opinion to avoid unnecessary psychological burden.