Nonspecific ST-segment And T-wave Changes - Wikidoc

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Schematic representation of normal ECG segments

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Synonyms and keywords: NSSTW changes

Overview

Non specific ST T wave changes refer to changes in the T waves (such as inversion or flattening) and ST segments (such as ST depression) on the electrocardiogram that due not follow an anatomic distribution and are not diagnostic of any one condition.

Causes of Non Specific ST Segment and T Wave Changes [1]

  • Adrenal insufficiency
  • Anxiety
  • Central nervous system diseases
  • Congestive heart failure
  • Digoxin
  • Electrolyte disturbances
  • Gallbladder disease
  • Heart failure
  • Hyperkalemia
  • Hyperventilation (in 70% of patients after 30 to 60 seconds)
  • Hypokalemia
  • Hypopituitarism
  • Hypothyroidism
  • Ischemic heart disease
  • Left ventricular hypertrophy (LVH)
  • Mitral valve prolapse (MVP)
  • Orthostatic changes (3 to 23%), most prominent in the inferior leads
  • Pacemaker
  • Pancreatitis
  • Pheochromocytoma
  • Postprandial T-waves changes
  • Pulmonary embolism
  • Pericarditis
  • Right ventricular hypertrophy (RVH)
  • Truncal vagotomy

References

  1. ↑ Hammill S. C. Electrocardiographic diagnoses: Criteria and definitions of abnormalities, Chapter 18, MAYO Clinic, Concise Textbook of Cardiology, 3rd edition, 2007 ISBN 0-8493-9057-5
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Electrocardiography
OverviewHistory of the EKG • EKG interpretation basics • Normal sinus rhythm
EKG ComplexesP wave • QRS complex • ST Segment • T wave • T wave alternans • Tombstone T wave • U wave

Osborn wave • H wave • K wave • Delta wave

NSSTW changes
EKG IntervalsPR Interval • QRS Interval • ST Interval • QT Interval
Conduction System & BradycardiaCardiac pacemaker • SA node • AV node• Bundle of His • Purkinje fibers • Sinus bradycardia • First Degree AV Block • Second Degree AV Block • Complete or Third-Degree AV Block • Concealed conduction • AV Junctional Rhythms • LBBB • LAHB • LPHB • RBBB • Trifascicular block
Atrial ArrhythmiasSinus tachycardia • Premature Atrial Contractions (PACs) • Ectopic Atrial Rhythm • Paroxysmal Atrial Tachycardia (PAT) • Paroxysmal Atrial Tachycardia (PAT) with Block • Multifocal Atrial Tachycardia (MAT) • Atrial Flutter • Atrial Fibrillation • Wandering atrial pacemaker
Ventricular ArrhythmiasDifferential Diagnosis of Tachycardia with a Wide QRS Complex • Accelerated Idioventricular Rhythm • Ventricular Parasystole • Premature Ventricular Contractions (PVCs) • Ventricular tachycardia • Ventricular Fibrillation • Sudden cardiac death
EKG Abnormalities in Disease StatesHypertrophy & Dilatation • Right atrial enlargement • Left atrial enlargement • Biatrial enlargement • Left Ventricular Hypertrophy • Right Ventricular Hypertrophy • Biventricular Hypertrophy •

Acute myocardial infarction • NSTEMI • STEMI • Tombstone ST elevation • Right ventricular myocardial infarction • Atrial infarction

Pre-excitation Syndromes • Wolff-Parkinson-White Syndrome • Lown Ganong Levine Syndrome • Mahaim Type Preexcitation

Cardiomyopathies • Arrhythmogenic Right Ventricular Dysplasia • Dilated Cardiomyopathy • Hypertrophic Cardiomyopathy

Drug Effects on the EKG • Adenosine • β-blockers • Digitalis • Quinidine • Procainamide • Disopyramide • Lidocaine • Tocainide and Mexiletine • Phenytoin • Encainide, Flecainide and Propafenone • Amiodarone • Bretylium • Ca Channel Blockers • Phenothiazines • Tricyclic Antidepressants • Lithium

Congenital Heart Disease • Dextrocardia • Atrial Septal Defect • Ventricular Septal Defect • Tetralogy of Fallot • Conjoined Twins or Siamese Twins • Congenital heart block

Electrolyte Disturbances • Hyperkalemia • Hypokalemia • Hypercalcemia • Hypocalcemia • Nonspecific Changes

Other Heart Diseases • Pericarditis • Myocarditis • Tamponade • Heart Transplantation • Sick Sinus Syndrome • Long QT Syndrome

Inherited Disease • Brugada Syndrome

Systemic Diseases • CNS Disease • Cardiac Tumors

Heart Transplantation • EKG Changes in patient with Heart Transplantation

Exogenous Effects • Hypothermia • Chest Trauma • Insect Bites • Electric Injuries
Technical Issues and Potential Errors in InterpretationArtifacts • Lead Placement Errors • The EKG in a Patient with a Pacemaker • EKG in athletes

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Retrieved from "https://www.wikidoc.org/index.php?title=Nonspecific_ST-segment_and_T-wave_changes&oldid=751438" Categories:
  • Electrophysiology
  • Cardiology
  • Emergency medicine
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