114
edits
ST Morphology: Difference between revisions
Jump to navigation
Jump to search
no edit summary
No edit summary |
No edit summary |
||
| Line 41: | Line 41: | ||
*[[Miscellaneous#Cardiac contusion|Cardiac contusion]] | *[[Miscellaneous#Cardiac contusion|Cardiac contusion]] | ||
*[[Chamber_Hypertrophy_and_Enlargment|Left ventricular hypertrophy]] | *[[Chamber_Hypertrophy_and_Enlargment|Left ventricular hypertrophy]] | ||
*[[Idioventricular Rhythm|Idioventricular rhythm]] including [[Pacemaker| | *[[Idioventricular Rhythm|Idioventricular rhythm]] including [[Pacemaker|paced rhythm]] | ||
In a study by Otto et al. among 123 patients with chest | In a study by Otto et al. among 123 patients with chest pain and ST segment elevation of >1mm 63 patients did not have a myocardial infarction. Diagnoses in patients who did not have a myocardial infarction were [[LVH]] (33%) and [[LBBB]] (21%). <cite>Otto</cite> In daily practice this means that in these patients the diagnosis of myocardial infarction has to depend on other diagnostic means, such as laboratory tests, echocardiography and coronary angiography. | ||
An important clue for the diagnosis of ischemia is the presence of [[Ischemia|reciprocal ST depression]]. | An important clue for the diagnosis of ischemia is the presence of [[Ischemia|reciprocal ST segment depression]]. | ||
[[Image:early_repol.png|thumb|none|Characteristics of early repolarization]] | [[Image:early_repol.png|thumb|none|Characteristics of early repolarization]] | ||
'''Early repolarization''' is a term used for ST elevation without underlying disease. It probably has nothing to do with actual early repolarization. It is commonly seen in young men. It is important to discern early repolarization from ST elevation from other causes such as [[ischemia]]. Characteristics of early repolarization are:<cite>Kambara</cite> | '''Early repolarization''' is a term used for ST segment elevation without underlying disease. It probably has nothing to do with actual early repolarization. It is commonly seen in young men. It is important to discern early repolarization from ST segment elevation from other causes such as [[ischemia]]. Characteristics of early repolarization are:<cite>Kambara</cite> | ||
* an upward concave elevation of the RS-T segment with distinct or "embryonic" J waves | * an upward concave elevation of the RS-T segment with distinct or "embryonic" J waves | ||
* slurred downstroke of R waves or distinct J points or both | * slurred downstroke of R waves or distinct J points or both | ||
| Line 60: | Line 60: | ||
==ST depression== | ==ST depression== | ||
The most important cause of ST depression is [[Ischemia]]. Other causes of ST depression are: | The most important cause of ST segment depression is [[Ischemia]]. Other causes of ST segment depression are: | ||
*Reciprocal ST depression. If one | *Reciprocal ST segment depression. If one lead shows ST segment elevation then usually the lead 'on the other side' shows ST segment depression. (This is usually seen in [[ischemia]] as well. | ||
*Left [[Chamber_Hypertrophy_and_Enlargment|ventricular hypertophy]] with "strain" or depolarization abnormality | *Left [[Chamber_Hypertrophy_and_Enlargment|ventricular hypertophy]] with "strain" or depolarization abnormality | ||
*[[Miscellaneous#Digoxin|Digoxin]] effect | *[[Miscellaneous#Digoxin|Digoxin]] effect | ||
*[[Electrolyte_disturbances|Low potassium / low magnesium]] | *[[Electrolyte_disturbances|Low potassium / low magnesium]] | ||
*Heart rate induced changes (post | *Heart rate-induced changes (post tachycardia) | ||
*[[Clinical Disorders#ECG_changes_after_neurologic_events|During acute neurologic events]]. | *[[Clinical Disorders#ECG_changes_after_neurologic_events|During acute neurologic events]]. | ||