Generally ischemia (lack of blood flow): you’re looking for changes in the normal complex that indicate the presence. that would be ST depressions, or flipped T-waves on leads V2,V3 and V4 with a 12 lead EKG.
A lesion can cause Ischemia or an infarct: Ischemia is a blood vessel that is still open. An infarct is a vessel that is not open at all. In ischemia, what you get is usually ST depression, below the isoelectric line. An infarct will show ST elevation in all the leads that reflect whichever part of the heart is being affected.