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ST Morphology

69 bytes added, 06:06, 17 January 2010
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*[[Miscellaneous#Cardiac contusion|Cardiac contusion]]
*[[Chamber_Hypertrophy_and_Enlargment|Left ventricular hypertrophy]]
*[[Idioventricular Rhythm|Idioventricular rhythm]] including [[Pacemaker|Paced paced rhythm]]
In a study by Otto et al. among 123 patients with chest paint pain and ST segment elevation of > 1 mm 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 segment depression]].
[[Image:early_repol.png|thumb|none|Characteristics of early repolarization]]
'''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
* slurred downstroke of R waves or distinct J points or both
==ST depression==
The most important cause of ST segment depression is [[Ischemia]]. Other causes of ST segment depression are:
*Reciprocal ST segment depression. If one leads whos lead shows ST segment elevation than then usually the lead 'on the other siteside' shows ST segment depression. (this This is mostly usually seen in [[ischemia]] as well.
*Left [[Chamber_Hypertrophy_and_Enlargment|ventricular hypertophy]] with "strain" or depolarization abnormality
*[[Miscellaneous#Digoxin|Digoxin]] effect
*[[Electrolyte_disturbances|Low potassium / low magnesium]]
*Heart rate -induced changes (post tachycardialtachycardia)
*[[Clinical Disorders#ECG_changes_after_neurologic_events|During acute neurologic events]].


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