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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 | *[[Miscellaneous#Pulmonary_embolism|Longembolie]]: ST elevation in V1 and aVR | ||
*Hypothermie : V3-V6, II, III | *[[Miscellaneous#Hypothermia|Hypothermie]]: ST elevation in V3-V6, II, III and aVF | ||
* | *[[Miscellaneous#Hypertrophic_Obstructive_Cardiomyopathy|Hypertrophic cardiomyopathy]]: V3-V5 (sometimes V6) | ||
* | *[[Miscellaneous#Hyperkalemia|Hyperkalemia]: V1-V2 (V3) | ||
* | *[[Miscellaneous#ECG_changes_after_neurologic_events|During acute neurologic events:]] all leads, primarily V1-V6 | ||
*Acute | *Acute sympathic stress: all leads, especially V1-V6 | ||
*[[Brugada | *[[Brugada syndrome]]. | ||
*[[ | *[[Ischemia#Cardiac_Aneurysm|Cardiac aneurysm]]. | ||
* | *[Miscellaneous#Contusio_cordis_.2F_Commotio_cordis|Contusio Cordis]] | ||
{{clr}} | {{clr}} | ||
==ST | ==ST depression== | ||
The most important cause of ST depression is [[Ischemia]]. Other causes of ST depression are: | |||
* | *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. | ||
* | *Left [[ventricular hypertophy]] with "strain" | ||
*[[Miscellaneous# | *[[Miscellaneous#Digoxin|Digoxin]] effect | ||
*[[ | *[[Electrolyte_disturbances|Low potassium / low magnesium]] | ||
* | *Heart rate induced changes (post tachycardial) | ||
* | *[[Miscellaneous#ECG_changes_after_neurologic_events|During acute neurologic events:]. | ||
==T | ==T wave changes== | ||
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. | |||
A concise list of possible causes of T wave changes: | |||
*[[Ischemia| | *[[Ischemia|Ischemia and myocardial infarction]] | ||
*[[Miscellaneous#Pericarditis|Pericarditis]] | *[[Miscellaneous#Pericarditis|Pericarditis]] | ||
*[[Miscellaneous#Myocarditis|Myocarditis]] | *[[Miscellaneous#Myocarditis|Myocarditis]] | ||
* | *[Miscellaneous#Contusio_cordis_.2F_Commotio_cordis|Contusio Cordis]] (traumatic) | ||
*[[Miscellaneous#ECG_changes_after_neurologic_events|Acute | *[[Miscellaneous#ECG_changes_after_neurologic_events|Acute neurologic events]], such as a subarachnoid bleed. | ||
*[[w:Mitral_valve_prolapse| | *[[w:Mitral_valve_prolapse|Mitral valve prolapse]] | ||
*[[Miscellaneous# | *[[Miscellaneous#Digoxin|Digoxin effect]] | ||
* | *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 | |||
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. | ||