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ST segment depression and T-wave changes may be seen in patients with unstable angina; Depressed but upsloping ST segment generally rules out ischemia as a cause. Also, it can be a normal variant or artifacts, such as: Pseudo-ST-depression, which is a wandering baseline due to poor skin contact of the electrode [3]
Illustration of ST segment elevation and depression The normal ST segment has a slight upward concavity. Flat, downsloping, or depressed ST segments may indicate coronary ischemia. ST elevation may indicate transmural myocardial infarction. An elevation of >1mm and longer than 80 milliseconds following the J-point.
Plaques in the walls of the coronary arteries can rupture, resulting in occlusion of the artery and deprivation of blood flow and oxygen to the heart muscle, resulting in cardiac cell death. [9] This is known as myocardial infarction. [9] A heart attack can cause arrhythmias, as well as permanent damage to the heart muscle. [25]
What causes vertigo and dizziness? “Dizziness is generally a more neurological cause or a potential cardiac cause. For example, it could be a blood flow issue or stenosis of a carotid artery ...
[4] [6] Unstable angina is considered to be present in patients with ischemic symptoms suggestive of an acute coronary syndrome and no change in troponin levels, with or without changes indicative of ischemia (e.g., ST segment depression or transient elevation or new T wave inversion) on electrocardiograms.
Diagnosis is based on an ECG showing ST-segment depression at the J-point of 1 to 3 mm in leads V1 to V6, with tall and symmetrical T waves. [1] The ST-segment is upsloping and there is also often ST-segment elevation of 0.5 to 2 mm in lead aVR. [1] [2] The QRS complex is either normal or slightly wide. [1]
The TIMI risk score can identify high risk patients in ST-elevation and non-ST segment elevation MI ACS [30] [31] and has been independently validated. [ 32 ] [ 33 ] Based on a global registry of 102,341 patients, the GRACE risk score estimates in-hospital, 6 months, 1 year, and 3-year mortality risk after a heart attack. [ 34 ]
When coronary vasospasm causes an artery to undergo complete occlusion, an EKG might show evidence of ST-segment elevation in the leads indicative of that artery's territory. Transient ST-segment depression can also occur, usually in the setting of sub-total occlusion of an artery.
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