Relevance of simultaneous ST segment elevation and depression in an exercise treadmill test

Simultaneous ST segment elevation and depression recorded during an exercise treadmill test and its correlation with coronary angiogram is a new finding that does not find a place in medical literature. We conclude that in the presence of simultaneous ST segment elevation and ST segment depression during exercise treadmill test (1) the localizing value of isolated ST elevation is lost and (2) there is severe triple vessel disease warranting early intervention.