<prompt> This is seen due toHypokalemiaHypercalcemiaDigoxinBeta blockers  <response>: In a patient taking digoxin. The ST-T complexes here are scooping - consistent with a digitalis effect. In the digitalis effect, the ST segments are often likened to a reverse tick or to the shape of Dalis moustache The impoant learning point here is that the digitalis effect does not necessarily mean toxicity. These ECG features can often be seen when digoxin levels are within the therapeutic range. 