ST Morphology: Difference between revisions

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[[Image:stelevatie_en.png|thumb|ST elevatie is measured 1,5 or 2mm (=60ms or 80ms) after the junctional or j-poin.<cite>Gibbons</cite>]]
[[Image:stelevatie_en.png|thumb|ST elevatie is measured 1,5 or 2mm (=60ms or 80ms) after the junctional or j-poin.<cite>Gibbons</cite>]]
The most important cause of '''ST elevation''' is '''acute [[Ischemia]]'''. Other causes are <cite>Wang</cite><cite>Werf</cite>:
The most important cause of '''ST elevation''' is '''acute [[Ischemia]]'''. Other causes are <cite>Wang</cite><cite>Werf</cite>:
*[Miscellaneous#Pericarditis|Acute pericarditis]: ST elevation in all leads except aVR
*[[Miscellaneous#Pericarditis|Acute pericarditis]]: ST elevation in all leads except aVR
*Longembolie : V1 en aVR  
*[[Miscellaneous#Pulmonary_embolism|Longembolie]]: ST elevation in V1 and aVR  
*Hypothermie : V3-V6, II, III en aVF
*[[Miscellaneous#Hypothermia|Hypothermie]]: ST elevation in V3-V6, II, III and aVF
*Hypertrofische cardiomyopathie : V3-V5 (kan ook nog V6)
*[[Miscellaneous#Hypertrophic_Obstructive_Cardiomyopathy|Hypertrophic cardiomyopathy]]: V3-V5 (sometimes V6)
*Hyperkaliëmie: V1-V2 (V3)
*[[Miscellaneous#Hyperkalemia|Hyperkalemia]: V1-V2 (V3)
*Acute neurologische aandoeningen: alle afleidingen, met name V1-V6
*[[Miscellaneous#ECG_changes_after_neurologic_events|During acute neurologic events:]] all leads, primarily V1-V6
*Acute sympathische stress: alle afleidingen, met name V1-V6
*Acute sympathic stress: all leads, especially V1-V6
*[[Brugada syndroom]].
*[[Brugada syndrome]].
*[[Contusio Cordis]].
*[[Ischemia#Cardiac_Aneurysm|Cardiac aneurysm]].
*Aneurysma Cordis
*[Miscellaneous#Contusio_cordis_.2F_Commotio_cordis|Contusio Cordis]]
{{clr}}
{{clr}}


==ST depressie==
==ST depression==
De belangrijkste oorzaak van ST-depressie is [[Ischemia]]. Overige oorzaken van ST depressie zijn:
The most important cause of ST depression is [[Ischemia]]. Other causes of ST depression are:


*Reciproke ST depressie. Als een ECG afleiding ST elevatie laat zien, laat de tegenoverliggende ECG afleiding ST depressie zien.  
*Reciprocal ST depression. If one leads whos ST elevation than usually the lead 'on the other site' shows ST depression. (this is mostly seen in [[ischemia]] as well.
*Linker [[ventrikelhypertrofie]] met "strain"  
*Left [[ventricular hypertophy]] with "strain"  
*[[Miscellaneous#Digitalis|Digitalis]] effect  
*[[Miscellaneous#Digoxin|Digoxin]] effect  
*[[Electrolytstoornissen|Hypokaliemie/Hypomagnesemie]]
*[[Electrolyte_disturbances|Low potassium / low magnesium]]
*Frequentie-gerelateerde veranderingen
*Heart rate induced changes (post tachycardial)
*Acute neurologische aandoeningen.
*[[Miscellaneous#ECG_changes_after_neurologic_events|During acute neurologic events:].


==T top veranderingen==
==T wave changes==
Veranderingen van de T top treden vrij 'makkelijk' op en er is een lange lijst van mogelijke oorzaken. Een veranderde T top kan een teken zijn dat er 'iets' aan de hand is, maar het zegt vaak niet veel over de ernst van de oorzaak.
The T wave is quite 'labile' and longs lists of possible causes of T wave changes exist. A changing T wave can be a sign that 'something' is abnormal, but it doesn't say much about the severity.


Mogelijke oorzaken van een T top verandering zijn:
A concise list of possible causes of T wave changes:
*[[Ischemia|Myocardinfarct]]
*[[Ischemia|Ischemia and myocardial infarction]]
*[[Ischemia|MyocardIschemia]]
*[[Miscellaneous#Pericarditis|Pericarditis]]
*[[Miscellaneous#Pericarditis|Pericarditis]]
*[[Miscellaneous#Myocarditis|Myocarditis]]
*[[Miscellaneous#Myocarditis|Myocarditis]]
*[[Miscellaneous#Contusio cordis|Contusio cordis]] (door trauma)
*[Miscellaneous#Contusio_cordis_.2F_Commotio_cordis|Contusio Cordis]] (traumatic)
*[[Miscellaneous#ECG_changes_after_neurologic_events|Acute neurologische aandoeningen]], zoals een subarachnoïdale bloeding
*[[Miscellaneous#ECG_changes_after_neurologic_events|Acute neurologic events]], such as a subarachnoid bleed.
*[[w:Mitral_valve_prolapse|Mitralisklepprolaps]]
*[[w:Mitral_valve_prolapse|Mitral valve prolapse]]
*[[Miscellaneous#Digitalis|Digitalis effect]]
*[[Miscellaneous#Digoxin|Digoxin effect]]
*Rechter en linker [[Ventrikelhypertrofie|ventrikelhypertrofie]] met "strain"
*Right and left [[Ventricular hypertrophy|ventricular hypertrophy]] with strain
 
===Criteria for a pathological T wave===
;flat T wave: < 0.5 mm negative or positive in leads I, II, V3, V4, V5 of V6


===Criteria pathologische T-top===
  T vlak: <0,5 mm negatief en positief in afleiding I II V3 V4 V5 of V6.  
  T vlak: <0,5 mm negatief en positief in afleiding I II V3 V4 V5 of V6.  
  T negatief: >0,5 mm negatief in afleiding I II V3 V4 V5 of V6.  
  T negatief: >0,5 mm negatief in afleiding I II V3 V4 V5 of V6.  

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