St segment depression with tachycardia

St segment depression with tachycardia

When interpreting an ECG,
the PQ interval is usually taken as the isoelectric line. The TP segment represents a true contour line, but is practically not used in most routine clinical measurements. The appearance of J-point depression > 0.10 mV (1 mm) from the PQ transition level with a relatively flat ST segment (eg, 0.10 mV and duration 80 ms after the J-point (ST 80) for three consecutive cardiac cycles with stable isolines are considered a pathological response.As a rule, an ST 60 measurement should be taken whenever the heart rate is > 130 beats/min. ST segment depression can be observed at rest.

In this case, point J

and ST 60 or ST 80 must further decrease by >0.10 mV to be considered abnormal. Most laboratories print ECGs in 3x4 or 2.5 sec format for a group of three leads. To increase compliance with the above criteria, some laboratories have adopted a strategy of recording ECGs in leads II, aVF, and V5 for 10 seconds after changes below the ischemic threshold occur.

This is a 10 second recording

increases the likelihood of identifying several consecutive pathological cardiac cycles with a stable isoline.
When ST segment depression
is >0.1 mV, the stress ECG becomes less specific and imaging studies should be considered. In patients with early repolarization and ST segment elevation at rest, a return to the PQ transition level is normal, so the degree of FN-induced ST segment depression in patients with early renolarization should be determined from the level of the PQ interval, and not from the elevated position of the J point before the test.

ST segment depression

, induced by load, not only does not determine the localization of myocardial ischemia, but does not even indicate which coronary artery it is associated with. Unlike depression, exercise-induced ST-segment elevation is relatively specific in identifying the area of ​​ischemia and the coronary artery that may be causing that ischemia.

ST segment depression

If the myocardium experiences a significant or critical oxygen deficiency, a cascade of biochemical changes occurs, as a result of which certain changes appear on the ECG - ST segment depression.

Such changes in most cases should be regarded as acute until proven otherwise. But sometimes depression persists on the ECG for years, even in people who do not have problems with the coronary arteries. Only the clinical picture will allow you to decide on the tactics of patient management.

So, first of all, let's look at where this ST segment is located on the ECG.

On the left you see a schematic representation of an individual complex and ST segment. If you draw an imaginary line (ISOLINE) from the beginning to the end of the complex, then it will just pass through the ST segment. That is, in this particular case, there is neither elevation nor depression. This should be normal. If the segment were below the isoline it would be called “depression”, if on the contrary, above the isoline it would be called “elevation”.

It should be noted that elevation or depression are not always pathological, it depends on their severity

Normal, at rest

in the chest leads the depression should be less than 0.5 mm.

in the limb leads the depression should be less than 0.5-1 mm.

Let's look at a fragment of the ECG

First you need to draw an isoline; the accuracy of all subsequent measurements depends on the correctness of this stage. You need to find a more or less even section of the isoline between the two complexes and draw a line through them using a ruler. This will be the isoline. Well, something like this (see below)

Now it is clearly visible that the ST segment is under the isoline. But what to do now? Where to measure this very depression? It is clear that you need to apply the ruler vertically (perpendicular to the segment) and measure from the isoline to the line of the segment itself, but in what exact place should this be done?

Here you can see that if you choose a place arbitrarily, you can get completely different values ​​of depression. How to proceed? The answer is simple - the measurement must be carried out according to certain rules. You need to find the point (j) where the S wave ends, and if there is no S wave, then the point of intersection of the downward leg R with the isoline. Then from this point (j) you should retreat 0.08 s (4 mm at a belt speed of 50 mm/sec) and only then lower a perpendicular from it to the isoline. This point is called "point i" . Some foreign authors recommend retreating not 0.08 s, but 0.04 s. (2 mm). But if there is real depression, then it is more likely to be in both versions.

In our case, the situation will look like this

Thus, we can say that in lead V5 there is a depression of up to 0.5 mm (this is normal), and in V6 there is about 0.8 mm, which is outside the normal range. In this particular case, we cannot talk about ischemia, since we do not have depression in two adjacent leads. But in any case, such depression must be described in prison.

The next topic is the most important in the entire section "ISCHEMIA", ST Elevation and ST Elevation Infarction

But before moving on, complete the self-control exercise “ Task 5.2 - ST segment depression”

Obliquely ascending ST segments

Depression

The transition J point is considered normal at maximal exercise function, and a rapidly ascending ST segment (> 1 mV/sec) with a decrease of less than 0.15 mV (1.5 mm) after the J point should not be considered pathological. However, sometimes the ST segment decreases >0.15 mV (1.5 mm) over 80 ms after the J point. This type of slowly ascending ST segment may be the only ECG finding in patients diagnosed with stenotic coronary atherosclerosis and is largely dependent on the electrodes .

In patients

with a high probability of CAD, a slowly oblique ST segment with depression > 0.15 mV (1.5 mm) within 80 ms after the J point should be considered pathological. The significance of this finding in asymptomatic patients or those with a low likelihood of CAD has not yet been well studied. Increasing the degree of post-J point depression to >0.2 mV (2 mm) over 80 ms in patients with a slowly ascending ST segment increases specificity but decreases sensitivity.

Exercise- induced

may occur in the area of ​​Q-wave MI (Q-MI) or in a non-infected area. A rise of > 0.10 mV (1 mm) at the J point, a constant rise of > 0.10 mV (1 mm) lasting 60 ms from the J point for three consecutive cardiac cycles with a stable baseline should be regarded as a pathological reaction. These changes are most common in patients with anterior myocardial infarction, examined soon after its development, with a decrease in detection frequency by 6 days.

All patients without exception after MI

with stress-induced ST segment elevation have a lower EF, more severe resting wall motion abnormalities, and a worse prognosis than patients without elevation. ST segment elevation during exercise in leads with a pathological Q wave is not a sign of more severe coronary artery disease and rarely indicates myocardial ischemia. FN-induced ST-segment elevation may occasionally occur in patients with reversion to the embryonic R wave after acute MI; the clinical significance of such observation is similar to the recording of the Q wave.

When a patient has no MI

During FI, the ST segment rises in the lead where the Q wave is not recorded, this should be considered as a sign of transmural ischemia caused by coronary vasospasm or severe arterial occlusion. This occurs relatively infrequently: in = 1% of patients with stenotic coronary atherosclerosis. The ECG sign in the form of ST segment elevation quite specifically indicates the “interested” CA, and myocardial perfusion scintigraphy usually reveals a perfusion defect in the territory of this CA.

ST segment depression: causes and treatment methods

Forms of depression

26.12.2017

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A downward displacement of the ST segment relative to the isoelectric line (depression) is a reason for a more detailed examination of the patient, since the presence of such a change allows one to suspect ischemia of the heart muscle.

It should be remembered that analysis of this segment alone in isolation from the overall picture of the electrocardiogram is not informative enough. A correct conclusion is possible only after a comprehensive detailed analysis of the recording in all leads.

A segment on a cardiogram is a section of the curve located between adjacent teeth. The ST segment is located between the negative S wave and the T wave.

The ST segment is a fragment of the electrocardiogram waveform that reflects the period during which both ventricles of the heart are fully involved in the excitation process.

The duration of the ST segment on the ECG depends on the heart rate and changes with it (the higher the heart rate, the shorter the duration of this section on the cardiogram).

Each section of the electrocardiographic curve has its own diagnostic value:

On a normal cardiogram in the limb leads, the ST segment has a horizontal direction and is located on the isoelectric line. However, its position is also recognized as a variant of the norm, slightly above the isoelectric line (one and a half to two cells). This picture on the electrocardiogram is often combined with an increase in the amplitude of the positive T wave.

When analyzing an electrocardiogram, the greatest attention is paid to this segment when coronary heart disease is suspected and when diagnosing this disease, since this section of the curve is a reflection of oxygen deficiency in the heart muscle. Thus, this segment reflects the degree of myocardial ischemia.

The conclusion about ST segment depression is made when it is located below the isoelectric line.

The descent of the ST segment below the isoline (its depression) can also be recorded on the cardiogram of a healthy person; in this case, the position of the electrocardiogram curve in the ST segment does not fall below half a millimeter of the isoelectric line.

When analyzing an electrocardiogram, it is necessary to take into account that modifications of some of its elements can be caused by medications that the patient is taking, as well as deviations in the electrolyte composition of the blood.

Downward displacement of the ST segment relative to the isoelectric line is a nonspecific sign. This electrocardiographic phenomenon is observed in various leads in a number of conditions:

• Subendocardial or acute transmural ischemia (in acute myocardial infarction).
• Acute myocardial ischemia of the anterior wall of the left ventricle. This may also be indicated by ST elevation in the precordial leads.
• Acute ischemia of the lower wall.
• The result of exposure to drugs of the cardiac glycoside class.
• Hyperventilation of the lungs (excess oxygen in them).
• Reduced potassium content in the peripheral blood (hypokalemia) - in this case, there is a possibility of an additional U wave.
• Hypertrophic changes in the left ventricle, which in some cases can be interpreted as a sign of its overload.
• The horizontal displacement of this segment downwards is specific for the chronic course of coronary circulatory failure with myocardial ischemia.
• Vegetovascular dystonia.
• Pregnancy. During this period, a shift of the ST segment below the isoelectric line may be recorded against the background of tachycardia; the degree of depression in these cases does not exceed 0.5 mm.

A change in the ST-T complex in the form of its displacement down relative to the isoelectric line can be caused by a complex of reasons. For example, in a patient with myocardial hypertrophy (of any origin) and receiving therapy in the form of cardiac glycosides, there is a possibility of acute subendocardial ischemia.

Detection of ST segment depression is the reason for a thorough analysis of the electrocardiogram recording in all leads for a more accurate diagnosis of the location of the lesion.

In typical cases, myocardial ischemia (hypoxia) is manifested by pressing pain, discomfort, and burning in the chest area. Irradiation of pain to the back and left upper limb is typical. A painless form of myocardial ischemia is also possible, manifested by feelings of discomfort in the chest space, tachycardia, a decrease or increase in blood pressure, heartburn, and shortness of breath.

In the differential diagnosis of ischemic myocardial damage with VSD, the features of the clinical picture are taken into account: vegetative-vascular dystonia is characterized by ST depression in a young patient, more often in women, against the background of an increase in heart rate, in the absence of symptoms typical of angina pectoris. In this case, changes in the electrocardiogram are regarded as “nonspecific” or as “signs of increased influence of the sympathetic nervous system.”

With transient ischemia, Holter monitoring (recording an ECG during the day) helps make a diagnosis. The Holter displays all episodes of oxygen starvation of the heart muscle of patients that occurred during the day.

Application of Holter

In order for treatment to be effective, it is necessary to act directly on the cause of hypoxia, which is determined using special examination methods. Possible reasons are:

• atherosclerotic vascular lesions;
• unbalanced diet containing excessive amounts of cholesterol;
• emotional stress;
• presence of bad habits;
• sedentary lifestyle;
• excessive physical activity when the body is unprepared;
• metabolic disorders in the body leading to obesity;
• diabetes.

When treating myocardial ischemia, complex therapeutic regimens are used, consisting of the following drugs described in the table:

If conservative therapy is insufficiently effective, surgical treatment methods are used:

• stenting of coronary arteries and (or) their branches;
• coronary artery bypass grafting.

In the treatment of vegetative-vascular dystonia, the main role belongs to the normalization of the excitability of the nervous system. The amino acid Glycine is capable of normalizing the metabolism of nervous tissue. The beneficial effect of this substance on nervous tissue helps to reduce the astheno-neurotic component.

It is also advisable to use nootropic drugs with an additional sedative effect.

If tachycardia or tachyarrhythmia is present in vegetative-vascular dystonia, the use of Corvaldin, Corvalol, and potassium preparations is indicated.

For effective treatment of vegetative-vascular dystonia, it is necessary to adhere to a protective regime: giving up bad habits, a balanced diet, combating physical inactivity, and eliminating stress. Massage, physiotherapy and acupuncture show high effectiveness, especially as part of complex therapy.

Source: https://neurofob.com/mood-disorders/depression-forms/depressiya-segmenta-st.html

ST SEGMENT DEPRESSION, STRAIGHT EXTRASYSTOLIA

Dear Eduard Romanovich, I need your advice.

I am 57 years old, height 166 cm, weight 84 kg. Sedentary work. I hardly do sports. From early childhood, fate tested the strength of my nervous system. All my life I was weak and suffered from sore throats very often (up to the age of 45). At the age of 47, I suffered from Reactive Rheumatoid Arthritis. I was treated at the Rostov State Medical University. Despite this, I never complained in my heart.

But, for the last 4 years I have been caring for my 80-year-old mother. She has dementia. The horror is that it doesn't let me sleep at night. That is, as soon as I fall into a deep sleep, she abruptly pulls me out of it. This happens up to 20 times a night. For the last six months, I have been bothered by somersaults in the area of ​​my heart, “in the pit of my stomach.” When they became very frequent and long-lasting, I did an ultrasound of the heart and Holter. Here are the results (briefly):

ST segment: what is it and what is it responsible for

In electrocardiography of the heart, a segment is the portion of the curve located between adjacent teeth. The ST segment is located between points S and T. The S wave should always be located below the isoelectric line (it is negative), the T wave is most often located above (positive). The condition of the site needs to be assessed holistically; Most often, this segment of the graph can be used to determine how well oxygen saturates the myocardium.

A post shared by LEGAL PSYCHOLOGIST (@alenushkalen) on Apr 3, 2019 at 12:17am PDT

The size of the area under study can be different: the more frequent a person’s heartbeats, the shorter it is. Reflects the period when both ventricles are in an excited state. The area must be horizontal. Most often it is located approximately at the level of the isoelectric line, but in rare cases it can be located slightly higher, which is also considered a variant of the norm.

Sinus rhythm nonspecific depression st

› Varicocele

28.01.2020

For various heart disorders, the most common diagnostic method remains an ECG (electrocardiogram). This is a simple, quick and painless way to determine whether there are problems with the heart.

A separate specialist will decipher the cardiogram. It is a graph divided into segments. The ST segment is an important indicator, so deviations in this case may indicate serious diseases of the cardiovascular system or life-threatening conditions.

ST segment - what is it and what is it responsible for?

A segment on an ECG is a section of the curve that is located between adjacent teeth

As you know, only a doctor should decipher a cardiogram. It is very difficult for an untrained person to understand graphs. The ECG procedure itself is carried out very quickly, but at the same time it is quite informative.

It shows heart rate, heart rhythm, ventricular contractions, etc. The entire graph consists of various lines and segments, each of which performs its own function. It is worth remembering that it is necessary to evaluate the result completely; information solely on one segment will not yield much.

ST segment depression is not a disease, but an abnormality in the cardiogram. There may be several reasons for this condition and it is difficult to determine them without further examination.

The peculiarity of this segment is as follows:

1. The segment is located between points S and T, and the S wave is always negative, that is, it is below the isoelectric line. The T wave is usually located higher.
2. This segment is assessed holistically, but in most cases it shows how well the myocardium is saturated with oxygen.
3. The size of the segment depends on the heart rate. The more often the heart contracts, the shorter this section is.
4. The ST segment reflects the period of heart activity when both ventricles are in a state of excitation.
5. The ST section is always horizontal and located approximately at the level of the isoelectric line. However, if it is slightly higher (a couple of cells), then this is also considered normal.

Particular attention is paid to this area when diagnosing coronary artery disease and suspected myocardial infarction.

What does CT segment depression mean?

Depression is a condition in which the segment is located below the isoelectric line by more than 0.5 mm. The condition can be caused both by physiological characteristics and by the presence of pathological processes and diseases of the cardiovascular system.

Ischemic depression is possible: blood supply to part of the myocardium is stopped due to narrowing of blood vessels and arteries. Ischemia often causes a heart attack: the greater the amount of tissue that has died, the greater the threat to life.

Possible development due to vegetative-vascular dystonia. Pathology of the nervous system causes the development of arterial hypertension and affects the functioning of the heart muscle.

Depression may occur with excessively low potassium levels. A lack of this microelement leads to heart contraction disorders.

With tachycardia, ST segment depression is also possible. This type of deviation is called oblique; it is necessary to distinguish it from ischemic for timely and competent treatment of the disease.

May appear with hyperventilation. If the patient breathes frequently, shallowly, the tissues will become too saturated with oxygen; the carbon dioxide content will decrease. Most often diagnosed with fear, a stressful situation, or strong emotional arousal.

Possible development in pregnant women. Due to increased load on the heart and blood vessels, tachycardia may develop.

Causes of ST segment depression

ST segment depression can be observed in a number of disorders, pathologies and conditions

If the ECG shows a phenomenon such as ST segment depression, it is necessary to identify the reasons that led to this. They can be both physiological and pathological.

As a rule, strong deviations from the norm indicate the presence of pathology in the body. Such cases cannot be neglected; further examination of the body is necessary.

Among the causes of ST segment depression are:

• Myocardial ischemia. Ischemic damage to the myocardium means cessation of blood supply to part of it due to pathological narrowing of blood vessels or arteries, blockage of their lumen. Coronary heart disease usually occurs in parallel with a heart attack. This is a life-threatening condition. The threat directly depends on the degree of myocardial damage and the amount of dead tissue.
• Hyperventilation of the lungs. This syndrome is observed with frequent shallow breathing, when tissues are oversaturated with oxygen, and the level of carbon dioxide in the blood drops. This phenomenon can also lead to electrocardiogram abnormalities. The cause of this condition may be fear, stress, or strong emotional shock.
• Hypokalemia. As you know, potassium is an important element for heart function. Potassium supports normal muscle contractile function. Potassium deficiency occurs due to poor nutrition and metabolic disorders.
• Vegetative-vascular dystonia. This is a disease of the autonomic nervous system, which is accompanied by a whole range of symptoms. Dystonia affects heart function and blood pressure. The causes may be diseases of the endocrine system, hormonal imbalances, and severe stress.
• Pregnancy. During pregnancy, the load on the cardiovascular system increases significantly. A common occurrence is tachycardia in pregnant women. Due to increased heart rate, deviations from the norm may appear on the cardiogram.

Only a doctor can determine the degree of deviation. It must be remembered that before the examination, the doctor is informed about all medications taken. Some medications can affect the functioning of the heart and heart rate, which can lead to abnormalities in the cardiogram.

What symptoms accompany the deviation?

The clinical picture may differ depending on what disease led to the ST segment depression

Manifestations may be cardiac or non-cardiac. For example, such disorders are often accompanied by signs of real depression, a disorder of the nervous system, which can be both a consequence and a cause of the condition.

Common clinical manifestations include:

1. Chest pain. Pain does not always appear. With minor deviations, the disease is painless. Severe pain in the chest, radiating to the back and arm, may be signs of an incipient myocardial infarction. Often heart pain disappears after taking a nitroglycerin tablet.
2. Tachycardia. ST segment depression is accompanied by heart rate disturbances, most often palpitations. Tachycardia can manifest itself in various diseases of the cardiovascular system.
3. Difficulty in physical activity. If you have heart problems, heavy loads become impossible. During active sports, shortness of breath, tachycardia, chest pain and other unpleasant symptoms appear.
4. Dyspnea. The feeling of lack of air can occur both after exercise and at rest. The second is a more alarming sign and indicates a deterioration in the blood supply to the lung tissue.
5. Headache. Diseases of the cardiovascular system often occur against the background of hypertension. High blood pressure leads to vasospasm and migraines. Usually the pain is localized in the occipital region.

When contacting a cardiologist, it is very important to correctly and completely describe the existing symptoms. Taking an anamnesis will help in making a diagnosis. It is necessary to clarify when and after what symptoms appear, how intense they are and when they disappear.

You should also pay attention to symptoms such as cough. At first glance, it is not associated with heart disease, but coughing attacks can be caused by insufficient nutrition of the lung tissue. There may also be a feeling of tightness in the chest area, which is a sign of angina and needs to be examined.

Features of treatment and prognosis

To confirm the diagnosis, additional examinations are necessary. You will have to tell your doctor about any medications you are taking: medications can affect heart function. Blood samples must be provided for analysis. If there are blood clotting disorders, you should also tell your doctor about them. Conduct studies of the coronary arteries. Holter monitoring may be required. Assess the condition of the lungs and sinus rhythm. In addition, pay attention to concomitant symptoms and the general clinical picture.

Treatment depends on the cause. If myocardial ischemia is noted, antiplatelet agents, nitrates, adrenergic blockers, and statins are prescribed. If medications are not effective enough, surgical methods of intervention are used: coronary artery stenting, coronary artery bypass grafting. You should reduce body weight if you are overweight, walk in the fresh air more often, exclude foods with a lot of fat and sugar, and give preference to natural foods.

With VSD, it is necessary to normalize the state of the nervous system. Prescribe the amino acid Glycine to get rid of the neurotic component. In addition, doctors often prescribe nootropic and sedatives. Corvalol and potassium supplements may be prescribed. In addition, you should give up bad habits (smoking, drinking alcohol), normalize your diet, follow a drinking regime, avoid stress, and get enough rest.

Nonspecific depression of st heart what is it

1. Reduced concentration and attention are manifested in difficulty memorizing and low academic performance. Physical activity is also significantly reduced, to the point of stupor, which may be considered laziness. Adolescent and childhood depression is often accompanied by aggressive attacks and increased conflict, which hide self-hatred.
2. The mood becomes better in the evening. Self-confidence disappears and self-esteem decreases.
   Due to these feelings, the patient moves away from society and strengthens his emerging feeling of inferiority. Long periods of depression in patients over 50 years of age are accompanied by deprivation and a clinical picture that is similar to dementia.

   Constant gloomy thoughts, a pessimistic attitude, an increasing sense of guilt, self-deprecation - a familiar state? It is this that is most often shown in all films, associating it with the depression of the Art. segment. And the patient, just like in all such films, thinks about causing harm to himself, or even comes to thoughts of suicide.

3. The patient begins to sleep poorly, may have nightmares, and finds it very difficult to get up in the morning. Appetite worsens, and there is a frequent preference for carbohydrate foods over protein foods. The desire to eat may appear in the evening. A person in a state of depression has a distorted sense of time: for him it lasts a very long time.
4. Another important sign is a reluctance to take care of oneself, which leads to an extremely sloppy appearance, at a minimum.
5. Communication with such a person often comes down to discussing his past problems. The patient’s speech itself is slowed down, and the formulation of ideas becomes a difficult task for him.
6. During the examination, patients look at the light or out the window. Gestures are directed towards oneself, hands are pressed to the chest. During anxious depression, the hands are pressed to the throat, a Veragut fold is observed in facial expressions, and the corners of the mouth are lowered. When manipulating objects, actions will be fussy. The voice becomes lower and quieter, long pauses appear between each word, and low directiveness is noted.

Such reasons can indirectly confirm the diagnosis of st interval depression:

• Dilated pupils.
• Tachycardia.
• Constipation.
• Reduced elasticity of the skin, it becomes flabby.
• The brittleness of nails and hair is significantly increased.
• The patient seems much older than his years.
• Due to cravings for foods rich in carbohydrates, weight may increase uncontrollably.
• Sexual desire increases, because this reduces the level of anxiety.

What can cause depression?

1. At the genetic level, depression ct is caused by a pathology of the eleventh chromosome.
2. With the biochemical path of development of this diagnosis, the exchange of catecholamines and serotonin is complicated.
3. Neuroendocrine development manifests itself when the rhythm of the pituitary gland, hypothalamus and limbic system, as well as the pineal gland is disrupted, which is why the level of production of releasing hormones and melatonin is reduced. Daylight is involved in the creation of these hormones - the less of it, the worse the production.
4. Between the ages of twenty and forty, there are increased spikes in depression.
5. A sharp decline in a person's social class.
6. Presence of suicide in the family.
7. Loss of loved ones and relatives in adolescents over eleven years of age.
8. The risk group includes people with increased conscientiousness, diligence and anxiety.
9. Naturally, stressful events and problems with satisfying sexual desires also lead to depression.
10. Some doctors add homosexuality and the period after childbirth to this.

What does CT segment depression mean?

Depression is a condition in which the segment is located below the isoelectric line by more than 0.5 mm. The condition can be caused both by physiological characteristics and by the presence of pathological processes and diseases of the cardiovascular system.

Possible development due to vegetative-vascular dystonia. Pathology of the nervous system causes the development of arterial hypertension and affects the functioning of the heart muscle.

Depression may occur with excessively low potassium levels. A lack of this microelement leads to heart contraction disorders.

With tachycardia, ST segment depression is also possible. This type of deviation is called oblique; it is necessary to distinguish it from ischemic for timely and competent treatment of the disease.

May appear with hyperventilation. If the patient breathes frequently, shallowly, the tissues will become too saturated with oxygen; the carbon dioxide content will decrease. Most often diagnosed with fear, a stressful situation, or strong emotional arousal.

Possible development in pregnant women. Due to increased load on the heart and blood vessels, tachycardia may develop.

How does depression develop?

Recent research in the field of st segment depression has helped to compose three options for the development of anxiety and arterial hypertension:

• Due to somatovegetative disorders, depression begins and hypertension additionally develops. Due to increased nerve impulses, pressure increases in the smooth muscles of peripheral vessels. In this option, neurocircular dystonia or hypertension is treated, but the initial alarming factor remains unknown.
• Arterial hypertension develops, and only then anxiety depression is added. This disease is considered a more dangerous form for treatment. Using electrocardiography, the brain component can be identified, which will allow the diagnosis of the disease.
• In the third and final version, depression manifests itself as a complication of arterial hypertension. Due to increased symptoms, hypertension and depression, unique clinical pathologies arise, which allows for accurate diagnosis.

The National Heart Center conducted a number of studies. In patients with arterial hypertension, an increased degree of anxiety was observed and there was a high risk of depression when the patient changed his group from the first to the third.

After analyzing the medical records of inpatients, we found that doctors could have made mistakes when prescribing treatment for patients with hypertension. Due to the fact that attention was paid to the patient's anxiety extremely rarely, the ability of antihypertensive drugs to resist the disease fell further and further.

When making a diagnosis, the doctor is based on the reasons given by the patient. But you should always check for possible mental disorders. With such violations, the clinical picture will be disrupted.

In current realities, st depression and arterial hypertension should be monitored by both a psychiatrist and a cardiologist. Naturally, it is important that the patient himself participates in the course of treatment, because it is he who uses the drugs and follows the regimen that the doctor prescribed for him.

Features of treatment and prognosis

To confirm the diagnosis, additional examinations are necessary. You will have to tell your doctor about any medications you are taking: medications can affect heart function. Blood samples must be provided for analysis. If there are blood clotting disorders, you should also tell your doctor about them.

Treatment depends on the cause. If myocardial ischemia is noted, antiplatelet agents, nitrates, adrenergic blockers, and statins are prescribed.

If medications are not effective enough, surgical methods of intervention are used: coronary artery stenting, coronary artery bypass grafting.

You should reduce body weight if you are overweight, walk in the fresh air more often, exclude foods with a lot of fat and sugar, and give preference to natural foods.

With VSD, it is necessary to normalize the state of the nervous system. Prescribe the amino acid Glycine to get rid of the neurotic component. In addition, doctors often prescribe nootropic and sedatives.

Corvalol and potassium supplements may be prescribed.

In addition, you should give up bad habits (smoking, drinking alcohol), normalize your diet, follow a drinking regime, avoid stress, and get enough rest.

Prevention methods include a healthy lifestyle. In addition, you should regularly visit doctors to promptly detect emerging pathologies and treat them. The prognosis is more favorable if there is a mild form of pathology.

How to analyze the causes of depression?

First, let's recap the possible symptoms of ST segment depression:

1. Excess oxygen in the lungs.
2. Low potassium levels.
3. Long-term use of antiarrhythmic drugs.
4. Increased concentration of adrenal hormones due to frequent stress.
5. Fibrosis, subendocardial ischemia.

Potassium deficiency is detected on the cardiogram by a pronounced U wave with ST segment depression.

Atrial repolarization is noted in leads avf, 3, 2 with a decrease in st. The same situation can be seen with pulmonary emphysema.

Let's explain the rules that doctors use when observing the electrocardiogram of a patient suffering from coronary artery disease:

• The traditional method involves considering the shift in QRS cycles that are above the isoline.
• The bias level itself is found by comparing it with PQ. If you forget about this point, you can mistakenly establish segment elevation.
• The starting point of measurement is located after the end of the QRS for sixty to seventy seconds. This is a general standard. In case of ventricular repolarization or suspicion of this, the PQ level is taken as the point.
• Leads AVR and V1 do not make it possible to understand whether the segment has increased or not.
• With a heart rate exceeding one hundred and thirty beats per minute, pathologies can be seen, which incorrectly signals false elevation due to the hard work of the myocardium.

What are the symptoms of ischemic segment depression?

It is not always possible to see such a disease based on clinical symptoms. It is rarely possible to detect pathology during a medical examination. A symptom can be called pain, the source of which is located behind the sternum.

If it is present, the doctor carefully examines the source of pain, using the Metelitsa classification:

1. No pain in the pit of my stomach.
2. Physical activity is accompanied by pain in the chest.
3. Pain in the pit of the stomach, which makes physical activity impossible.
4. Pain that dissipates with Nitroglycerin.

Additional visual characteristics of the diagnosis are cold sweat and skin, its blueness, rapid breathing, and muscle fatigue.

To assess the ability of the heart muscle to respond to an increase in contraction frequency, tests using physical activity must be performed.

A healthy person has no pathologies, because his heart responds adequately to increased load. With physical activity, arterial hypertension decreases, in rare cases increasing systolic pressure.

In the presence of a previous myocardial infarction, myocardial ischemia is called an important reason for low blood pressure. With pathologically frequent contractions of the heart, reduced functional cardiac capabilities indicate ventricular dysfunction. This situation occurs when using cardiotropic drugs.

Source: https://remson58.ru/nespetsificheskaya-depressiya-serdtsa/

What is the ST segment?

An ECG shows the electrical processes that occur in the heart muscle during contraction and relaxation. If you look at the result of the study, you can see a line with many teeth. A straight segment is called an isoline, and the distance between two adjacent teeth is called a segment.

The ST segment represents the interval from the end of the S wave to the beginning of the T wave. This segment shows the state of the heart muscle at the time of contraction of both ventricles. Normally, the segment lies completely on the isoline and does not deviate from it. If the segment is located below the isoline, then doctors talk about depression of the ST segment.

Does this indicate a dangerous heart pathology? It all depends on the degree and type of segment decline. The electrocardiograph records the examination results on checkered paper. If the ST segment is located no more than half a cell below the isoline, then this is a variant of the norm and occurs in healthy people. This result is considered acceptable in both precordial and limb leads. A stronger decrease in the segment may indicate cardiac pathology.

What does ST segment depression mean in an electrocardiogram?

• July 23, 2018
• Psychiatry
• Evdokimova Irina

Sometimes in the transcript of the electrocardiogram the doctor writes about ST-segment depression. In some cases, this is a sign of pathology, but it can also be a normal variant. Patients do not always understand this term, so you should understand in more detail the reasons for this ECG result.

What is the ST segment?

An ECG shows the electrical processes that occur in the heart muscle during contraction and relaxation. If you look at the result of the study, you can see a line with many teeth. A straight segment is called an isoline, and the distance between two adjacent teeth is called a segment.

The ST segment represents the interval from the end of the S wave to the beginning of the T wave. This segment shows the state of the heart muscle at the time of contraction of both ventricles. Normally, the segment lies completely on the isoline and does not deviate from it. If the segment is located below the isoline, then doctors talk about depression of the ST segment.

Does this indicate a dangerous heart pathology? It all depends on the degree and type of segment decline. The electrocardiograph records the examination results on checkered paper.

If the ST segment is located no more than half a cell below the isoline, then this is a variant of the norm and occurs in healthy people. This result is considered acceptable in both precordial and limb leads.

A stronger decrease in the segment may indicate cardiac pathology.

Why is the ST segment reduced?

The causes of ST segment depression are divided into coronary and non-coronary. Coronary causes include conditions associated with insufficient blood supply (ischemia) to the heart muscle. These are different types of coronary heart disease and myocardial infarction. Non-coronary causes include:

• lack of potassium in the body (hypokalemia);
• secondary myocardial lesions in non-cardiac pathology;
• paroxysmal supraventricular tachycardia (ST segment depression can be up to 8 mm);
• taking certain medications (cardiac glycosides, antiarrhythmics, phenothiazines);
• hypertrophy of the left ventricle of the heart;
• vegetative dystonia;
• mitral valve prolapse;
• emotional stress;
• intense breathing (hyperventilation).

Types of segment reduction

When making a diagnosis based on electrocardiogram results, the type of ST segment depression must be taken into account. In cardiology, there are several types of such deviations:

• oblique;
• oblique;
• horizontal.

Oblique and horizontal depressions may indicate the presence of cardiac pathology. An oblique decline sometimes occurs in healthy people.

Oblique and horizontal type of decline

If the segment between the teeth is an oblique line directed downwards, then in this case they speak of oblique depression of the ST segment. Such electrocardiogram readings are considered pathological. This indicates myocardial ischemia. Another reason for this result may be left ventricular failure.

A sign of insufficient blood supply to the heart muscle is horizontal depression of the ST segment. What it is? The segment between the S and T teeth is parallel to the isoline. This ECG result is also a marker of ischemia.

The status of the ST segment is checked in two adjacent leads. That is, the electrodes of the cardiograph are connected to two points located nearby, on the chest or on the limbs. And if a decrease in the segment was detected twice, then this, as a rule, indicates ischemia.

Oblique descent type

Oblique ST-segment depression is a deviation in the electrocardiogram when the line between the teeth is directed upward. This usually happens with tachycardia. This phenomenon may be temporary, for example when your heart rate increases after exercise. In this case, changes in the electrocardiogram do not indicate pathology.

But if a high T wave is observed on the electrocardiogram along with oblique ST segment depression, this may indicate a disease. This ECG result occurs in the acute stage of myocardial infarction, with left ventricular hypertrophy, hyperkalemia.

Nonspecific depression

A decrease in the distance between the S and T waves is not always associated with coronary heart disease. This can be observed both normally and in conditions where the blood supply to the myocardium is not impaired. Typically, such a decrease is caused by non-coronary causes. In this case, doctors talk about nonspecific ST-segment depression.

Such changes in the electrocardiogram can be observed under the following conditions:

• mitral valve prolapse;
• taking cardiac glycosides, diuretics, psychotropic drugs (the ST segment has a trough-shaped shape);
• vegetative-vascular dystonia;
• left ventricular hypertrophy;
• hypokalemia;
• tachycardia;
• cardiac conduction disorders;
• hyperventilation;
• inflammation of the pancreas;
• water and electrolyte disturbances;
• Wolff-Parkinson-White syndrome (a disease with periodic attacks of tachycardia).

In some cases, there are mixed causes of ST segment depression. For example, a patient may suffer from left ventricular hypertrophy and at the same time use cardiac glycosides. This can lead to the development of myocardial ischemia.

The photo shows an ECG of a patient who has been taking one of the potent heart medications for a long time. There is a noticeable decrease and trough-shaped shape of the ST segment.

It is difficult for a patient who does not have special medical knowledge to understand the results of an electrocardiogram. Sometimes it is necessary to prescribe additional research methods. The ECG interpretation must be shown to the attending cardiologist; only he will be able to make an accurate diagnosis.

Source: https://SamMedic.ru/338079a-chto-oznachaet-depressiya-st-segmenta-v-rasshifrovke-elektrokardiogrammyi

Why is the ST segment reduced?

The causes of ST segment depression are divided into coronary and non-coronary. Coronary causes include conditions associated with insufficient blood supply (ischemia) to the heart muscle. These are different types of coronary heart disease and myocardial infarction. Non-coronary causes include:

• lack of potassium in the body (hypokalemia);
• secondary myocardial lesions in non-cardiac pathology;
• paroxysmal supraventricular tachycardia (ST segment depression can be up to 8 mm);
• taking certain medications (cardiac glycosides, antiarrhythmics, phenothiazines);
• hypertrophy of the left ventricle of the heart;
• vegetative dystonia;
• mitral valve prolapse;
• emotional stress;
• intense breathing (hyperventilation).

Types of segment reduction

When making a diagnosis based on electrocardiogram results, the type of ST segment depression must be taken into account. In cardiology, there are several types of such deviations:

• oblique;
• oblique;
• horizontal.

Oblique and horizontal depressions may indicate the presence of cardiac pathology. An oblique decline sometimes occurs in healthy people.

Oblique and horizontal type of decline

If the segment between the teeth is an oblique line directed downwards, then in this case they speak of oblique depression of the ST segment. Such electrocardiogram readings are considered pathological. This indicates myocardial ischemia. Another reason for this result may be left ventricular failure.

A sign of insufficient blood supply to the heart muscle is horizontal depression of the ST segment. What it is? The segment between the S and T teeth is parallel to the isoline. This ECG result is also a marker of ischemia.

The status of the ST segment is checked in two adjacent leads. That is, the electrodes of the cardiograph are connected to two points located nearby, on the chest or on the limbs. And if a decrease in the segment was detected twice, then this, as a rule, indicates ischemia.

Oblique descent type

Oblique ST-segment depression is a deviation in the electrocardiogram when the line between the teeth is directed upward. This usually happens with tachycardia. This phenomenon may be temporary, for example when your heart rate increases after exercise. In this case, changes in the electrocardiogram do not indicate pathology.

But if a high T wave is observed on the electrocardiogram along with oblique ST segment depression, this may indicate a disease. This ECG result occurs in the acute stage of myocardial infarction, with left ventricular hypertrophy, hyperkalemia.

Nonspecific depression

A decrease in the distance between the S and T waves is not always associated with coronary heart disease. This can be observed both normally and in conditions where the blood supply to the myocardium is not impaired. Typically, such a decrease is caused by non-coronary causes. In this case, doctors talk about nonspecific ST-segment depression.

Such changes in the electrocardiogram can be observed under the following conditions:

• mitral valve prolapse;
• taking cardiac glycosides, diuretics, psychotropic drugs (the ST segment has a trough-shaped shape);
• vegetative-vascular dystonia;
• left ventricular hypertrophy;
• hypokalemia;
• tachycardia;
• cardiac conduction disorders;
• hyperventilation;
• inflammation of the pancreas;
• water and electrolyte disturbances;
• Wolff-Parkinson-White syndrome (a disease with periodic attacks of tachycardia).

In some cases, there are mixed causes of ST segment depression. For example, a patient may suffer from left ventricular hypertrophy and at the same time use cardiac glycosides. This can lead to the development of myocardial ischemia.

The photo shows an ECG of a patient who has been taking one of the potent heart medications for a long time. There is a noticeable decrease and trough-shaped shape of the ST segment.

It is difficult for a patient who does not have special medical knowledge to understand the results of an electrocardiogram. Sometimes it is necessary to prescribe additional research methods. The ECG interpretation must be shown to the attending cardiologist; only he will be able to make an accurate diagnosis.

Heart ST depression

Depression of the ST segment, or its decrease relative to the isoline by more than 1 mm, is a clinically significant sign. Such a change can be caused by both nonspecific and specific reasons, which are discussed below.

Non-cardiac and physiological causes include:

• errors on the part of medical staff when taking an ECG - incorrect application of electrodes or their poor contact with the patient’s skin;
• water and electrolyte disturbances that occur when drinking sea water in large quantities, dehydration, alcohol abuse, salt-free diet, anorexia, heavy physical activity, use of diuretics, as well as certain pathologies (diseases of the kidneys, gastrointestinal tract, thyroid gland, burns, significant blood loss);
• drinking very cold water;
• hyperventilation (increased air exchange in the human body).

What does ECG mean in decoding?

Nonspecific ST-T changes on the ECG in the form of its decrease relative to the isoelectric line are primarily associated with cardiac ischemia, as the most dangerous condition that can lead to death.

However, this change is nonspecific and can also occur with other disorders of the heart. To correctly interpret this deviation, differential diagnosis is necessary.

Why is the ST segment reduced in adults and children?

A decrease in the ST area on the ECG in adults and children can occur in the following cases: