Diffuse violation of the process of repolarization what is it

Various reasons can change the ongoing process:

  • Diseases of the cardiac and vascular systems – cardiosclerosis, left ventricular hypertrophy, vegetative-vascular dystonia, ischemia.
  • Factors not related to cardiovascular pathologies – hormonal disorders, dehydration, impaired renal function, pathology of the nervous system, increased frequency of excitation stage pulses to the heart.

Changes in the functional activity of mediators of adrenergic substances (adrenaline and norepinephrine) can cause some neoplasms. A pathological change in repolarization is observed with an increase in the QT segment, a decrease in the QT interval, and an syndrome of the early end of the excitation phase. Now we will dwell on each of them.

The main reason for the malfunctioning of ion channels is a hereditary predisposition. This phenomenon is quite rare and occurs in one person for 6 thousand. Due to the influence of a genetic factor in the cells of the heart muscle, the ion balance is disturbed, which leads to a lengthening of the excitation process. Such a disorder manifests itself at any age, its clinical signs are sudden and unreasonable tachycardia, which is displayed on the cardiogram as an increase in ventricular contractions with changes in the configuration of the QRS complex.

This condition is observed:

  • with an emotional outburst;
  • taking certain medications;
  • sudden loss of consciousness.

The timely establishment of deviations in the repolarization process in children is very important – this syndrome can cause sudden death

This deviation is also quite rare – its appearance is associated with congenital anomalies and gene mutations. Changing the length of the QT segment is caused by improper operation of the potassium channels. It is possible to diagnose a shortening of the repolarization phase if the patient has constant arrhythmia, fainting, frequent attacks of tachycardia, a sudden slowdown in heart rhythm.

A qualified cardiologist may suspect the presence of this pathology even with the appearance of “heartless” signs: an increase in body temperature, an increase in the concentration of calcium or potassium in the blood, a shift in the level of the medium (pH) towards acidity, and the use of cardiac digoxin glycoside. If the ECG records a QT interval of less than 0,33 seconds, this confirms a shortened repolarization process.

Until recently, this change was not considered a pathology. However, the results of recent scientific studies indicate that this disorder is considered sinus arrhythmia.

Today it is most common among young people who are actively involved in sports. A clear clinical symptomatology of the disease is not observed, but there are a number of reasons that can cause it:

  • excessive physical stress;
  • a change in blood balance of electrolytes;
  • ischemic disease;
  • prolonged hypothermia of the body;
  • diffuse change in the myocardium of one of the main chambers of the heart – the left ventricle;
  • increased blood lipid levels;
  • use of adrenostimulants;
  • disturbances in the complex of anatomical formations of the heart muscle.

It is difficult to detect early repolarization, but practicing cardiologists believe that people with this pathology often have cases of tachycardia and sudden cardiac arrest.

  • Diseases of the cardiac and vascular systems – cardiosclerosis, left ventricular hypertrophy, vegetative-vascular dystonia, ischemia.
  • Factors not related to cardiovascular pathologies – hormonal disorders, dehydration, impaired renal function, pathology of the nervous system, increased frequency of excitation stage pulses to the heart.

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What is diffuse repolarization disorder?

The heart is the main organ that works in its own rhythm and is not controlled by the human consciousness – independently setting the phases of work and rest. The absence of pathological processes in the body contributes to the stability of this balance. The basis of the heart muscle is three processes:

It is these phases that the electrocardiogram tracks. The most common change – a violation of the processes of repolarization on the ECG in adults requires close attention of cardiologists. Any organ of the human body is made up of cells. The heart muscle has a special potential that can move ions from the cell or vice versa. Its value depends on the state in which the cells are at the moment – excitement or rest.

The excitation phase consists of two processes:

  • the beginning is depolarization;
  • the end is repolarization.

In the stage of repolarization, the heart muscle is at rest, which lasts from 0,3 to 0,4 seconds. On the ECG film, this phenomenon is displayed on the QT segment, a deviation from the norm characterizes a violation of this process.

When making a diagnosis, the doctor evaluates the shape of the teeth and determines the presence (or absence) of lengthening of the QT interval

Diffuse violation of the repolarization process is a term often used by cardiologists that is used to decipher existing deviations in a cardiogram. In fact, such a condition is not a completely separate pathological condition, but only a process that can indicate both existing pathologies of the cardiovascular system and aging processes.

When people who do not have a medical education pay attention to the decoding of the cardiogram and see such a term, they ask how dangerous it is. Anyone wants to have an ideal cardiogram, but over time the cardiovascular system wears out, even without any pronounced pathological phenomena can cause the appearance of various deviations from the norm.

Most modern people who have crossed the 60-year age limit, when conducting an ECG, similar deviations from the norm are detected. In addition, at present, this deviation is not uncommon among young people. This condition itself does not pose a danger to life and does not affect the prognosis of other existing diseases.

Repolarization is one of the cyclic phases of the functioning of the heart muscle (myocardium), accompanied by the restoration of the electric membrane charge. In the absence of disturbances in the heart, sodium ions in the process of repolarization return to their original state, due to which the membrane electric charge is restored, normal indicators prevail on the cardiogram (there are no significant deviations).

If the repolarization process is impaired, cardiac activity is destabilized. Tissues and organs are deficient in the oxygen and nutrients transported by the blood required for normal functioning. As a result, the well-being worsens and the likelihood of developing many diseases of various systems increases.

The primary diagnostic method is an electrocardiogram.

Any disease or pathology is caused by various deviations and incorrect changes in the work of various systems of our body. Such irregular processes can be caused by both external and internal factors.

Such a pathological process can occur in a child during the period of active growth, and in an adult from an excess of physical activity. Strong stress can also affect changes.

All of these options are non-specific violations. .

Firstdisturbances in the work of the heart, which include ischemic disease, and abnormalities in the balance of electrolytes, and overstrain of the heart muscles
The secondit is necessary to name an unbalanced amount of hormones (adrenaline / norepinephrine), to which tissues have an increased sensitivity
The thirdis the incorrect effect of pharmacological preparations on the body, due to improper use or dosing of substances
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Important! Sometimes the appearance of pathology can be caused by some changes in the body. Often they are associated with a restructuring of the hormonal background and an increase in susceptibility. The main examples of such changes are pregnancy and menopause.

Violation of ventricular myocardial repolarization may also be non-specific. This primarily applies to adolescents, but so far, unfortunately, the causes of the pathological process are not exactly known.

The following classification of early repolarization syndrome exists:

  • with damage to the heart muscle and blood vessels;
  • no lesion.

The syndrome is also classified according to the severity on the electrocardiogram into 3 classes:

  1. Minimal (observed in a small number of leads, from 2 to 3).
  2. Moderate (the number of leads increases from 4 to 5).
  3. Maximum (6 or more leads).

According to statistics, deviations in the work of the heart are detected 3 times more often in males.

However, most often the disease appears during pregnancy or menopause in women, since at this time the sensitivity of the body increases significantly and the general hormonal background changes. The disease is detected, as a rule, during routine examinations, in case of any complaints about well-being.

At risk are both professional athletes who are experiencing constant physical activity, and people who have experienced hypothermia. And some doctors even claim that the disease is hereditary.

There is no generally accepted classification of the syndrome of premature myocardial repolarization. It is important to distinguish 2 variants of the syndrome:

  1. SRG, proceeding without damage to the cardiovascular and other systems;
  2. Anemia accompanied by damage to the cardiovascular and other systems.

Most often, disturbances in the cell repolarization phase are caused by changes in the following factors:

  • insufficient oxygen supply to the heart muscle (hypoxia);
  • a decrease in pressure in the bed of the coronary arteries;
  • a change in systolic pressure in the cavity of the ventricles of the heart.

The causes of such violations of ventricular repolarization in adults, there are quite a lot. For convenience, they were combined into several groups:

  • diseases of the cardiovascular system (ischemic, inflammatory, dystrophic origin, myocardial hypertrophy, diffuse change in the structure of the ventricles);
  • the presence of pathology from the nervous system (neurocirculatory dystonia, sympathoadrenal dysfunction);
  • dysregulation of the neuroendocrine system (increased production of hormones);
  • menopause and pregnancy;
  • exposure to certain drugs;
  • non-specific causes of development (the phenomenon of early repolarization).

Many studies by scientists indicate that dozens of different stimuli can precede disturbances in repolarization processes.

The reasons are divided into 3 main groups:

  1. Diseases of the neuroendocrine system of the body.
  2. Ischemia, hypertrophy, or electrolyte imbalance.
  3. The impact of medications, the uncontrolled use of drugs can lead to the development of heart disease.

Doctors also identify a group of non-specific causes of the development of disorders. Nevertheless, a clear list of factors provoking a violation of repolarization processes has not yet been formulated.

For example, adolescents are quite often diagnosed with such a deviation, which soon passes without any medical treatment.

In the case of a diffuse disorder, that is, changes that affect the entire heart muscle, symptoms appear associated with the general well-being of the person and with the heart rhythm.

Deviations in the work of the heart affect the functioning of the whole organism. .

So, the symptoms include:

  • pulse rate change;
  • pain in the heart;
  • changes in the rhythm of the heart;
  • prostration;
  • tearfulness and irritability.

The above symptoms may appear even at the start of the development process. However, patients rarely take such changes in their general well-being seriously, which means that they rarely turn to cardiologists in such cases.

However, it is at this stage of the development of the disease that you can quickly cope with it and normalize the work of the heart. .

So, the external manifestations of violations of the repolarization process are almost invisible, and therefore this deviation can only be detected by a doctor after an appropriate examination, for example, an ECG.

Diagnosis often distinguishes its early form, or early repolarization syndrome, from the overall picture of the disease. In this case, recovery begins earlier than expected.

Of course, there are much more subtleties, and all of them can be seen by a professional in the results of the ECG, on the basis of which therapy is prescribed. .

Numerous factors can intervene in this process. These can be diseases of the cardiovascular system, and non-heart related causes:

  • Left ventricular hypertrophy;
  • Coronary artery disease;
  • Cardiosclerosis;
  • Hormonal imbalance, malfunction of the kidneys or dehydration;
  • Diseases of the nervous system, rapid flow of “exciting” impulses to the heart;
  • The malfunctioning of adrenaline receptors may be due to some tumors.

Violation of repolarization processes: causes and treatment

Therapeutic procedures include the use of:

  • Mineral and vitamin complexes (contribute to meeting the needs of cells of a vital organ in essential substances).
  • Cocarboxylase hydrochloride (provides normalization of carbohydrate metabolism, prevents neurological disorders, improves the condition of the heart and blood vessels).
  • Corticotropic hormonal drugs (due to the content of cortisone, cardiac pathologies are eliminated).
  • Beta-blockers (eliminate concomitant diseases that affect the heart).

To increase the effectiveness of the treatment of diffuse disorders of the processes of repolarization in the myocardium, it is advisable:

  • Minimize consumption of fried, fat-rich foods, give up alcohol.
  • Vitaminize the diet.
  • Optimize the day (exclude physical overload, eliminate sleep disturbances).
  • Avoid stress, stabilize the psycho-emotional background.

In the absence of severe symptoms, as prescribed by the doctor, the treatment course is limited to organizational measures, potent medicines are not used.

If the prerequisites are created for the development of unsafe ventricular tachyarrhythmias, the QT interval shortening syndrome progresses, and conservative methods do not lead to improved dynamics, there is a need to install an electric pacemaker.

Of course, in the human body, every organ is important and has its own special purpose. But the most important, of course, is the heart – an organ that has a complex structure and produces the necessary processes that many do not even suspect about. Unfortunately, this mechanism is very sensitive and vulnerable, any malfunction in the body can negatively affect the work of the heart, which will lead to to the development of various diseases.

More can be said – studies have proven that the number of patients with heart ailments is growing almost every day, and their age, unfortunately, is only getting younger. Heart diseases are very serious, if they are not treated on time, then death often occurs. That is why every person should be attentive to their most important organ, without fail to pay attention even to minor malfunctions in the work of the “human motor”.

The author of the article: Nivelichuk Taras, Head of the Department of Anesthesiology and Intensive Care, work experience 8 years. Higher education in the specialty “General Medicine”. From this article you will learn: what is repolarization of the heart, what is a violation of the processes of repolarization in the myocardium – a separate disease with its symptoms or the manifestation of various heart diseases?

What changes in the ECG indicate this problem? Violation of the processes of repolarization is a medical term that doctors most often use to describe the characteristic picture on an electrocardiogram (ECG). This picture indicates problems with the very last part of the cardiac cycle – ventricular relaxation.

These disorders can be observed in both adults and children. A distinctive feature is that in children they most often have a benign character and do not pose a risk to their health, while in the elderly they are signs of serious heart diseases such as heart attack, ischemia, myocarditis. Changes in the ECG can be observed in all leads or in their part.

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In the first case, they talk about diffuse violations of the repolarization process, in the second – about focal. Diffuse changes indicate that the disorders spread to the entire heart muscle (e.g., myocarditis). In focal pathological process is limited, affecting only part of the heart (for example, blockade of the bundle of His or myocardial infarction). Cardiologists are involved in diseases that can lead to repolarization disorders.

Violation of repolarization is not a disease, but its symptom detected by doctors on an ECG. It is necessary to treat the disease itself, and not its manifestations on the cardiogram. After eliminating the causes of these disturbances, the ECG normalizes independently. The effectiveness of the therapy depends on the type of disease. The prognosis for repolarization disorders depends on the causes of changes in the ECG.

One of the common cardiological diagnoses is a violation of repolarization processes in the myocardium. Although this problem is not always accompanied by any symptoms, its consequences can be very unpleasant. Only a timely visit to a doctor will help to avoid exacerbating problems.

Read more about what are dangerous violations of repolarization processes, and how to treat them – later in the article.

The heart is a complex mechanism, any violation in which leads to malfunctions in the entire circulatory system.

One of the important points of functioning is the consistent reduction and relaxation of the heart, which ensures the correct blood flow.

The contractions occur due to the transmission of nerve impulses – a kind of signal from the brain about the need for such a function.

Phase distribution of electrical impulses

Repolarization is a process during which the membrane potential of a cardiomyocyte is restored. The membrane is preparing to receive a new signal and, accordingly, to reduce. At this moment, the ions return to their original place, which makes it possible to take the next impulse. Speaking of repolarization, cardiologists describe the picture on the ECG at the time of ventricular diastole.

The correct course of myocardial repolarization is very important, since in the absence of treatment there is a risk of developing other diseases of the cardiovascular system:

  • heart rhythm disturbances;
  • left ventricular hypertrophy;
  • coronary artery disease.

If we are talking about the entire muscle (diffuse changes), then the symptoms are often mild. Violation of myocardial repolarization may be accompanied by the following manifestations:

  • violation of blood flow;
  • nervous system disorders;
  • heart rhythm failures;
  • fast fatiguability.

Such symptoms are inherent in many heart diseases, therefore, after receiving alarming ECG results, additional studies are carried out.

Focal disorders of repolarization occur during blockages in different parts of the pathways.

It is interesting to note that even those under the age of 35 who lead a healthy lifestyle and regularly engage in sports suffer from repolarization disorders.

As mentioned above, ventricular repolarization threatens not only older people, but also young and active ones (early ventricular repolarization syndrome stands out separately).

Any diffuse disorders may occur due to:

  • other heart diseases;
  • too intense physical exertion;
  • constant stress;
  • increased levels of adrenaline and norepinephrine;
  • hormonal disorders;
  • electrolyte disturbances in the blood;
  • taking certain drugs.

In general, this condition is rarely the reason for going to the doctor. It is fixed during the examination for specific signs on the cardiogram:

  • irregular T wave;
  • systematically raising the ST by 1-3 mm above the contour;
  • rounded ST view;
  • expansion at the base of tooth T.

In any case, only a specialist can determine the disease.

In women during pregnancy, a violation of the process of proper repolarization in the myocardium is also often observed. This is due to the increased load on the muscle, and, as a rule, passes after the birth of the baby.

ECG will detect abnormalities

Violation of repolarization is not considered a separate diagnosis, it is a symptom. Which indicates the occurrence of pathological processes and heart diseases. In the treatment of a pathological disorder, normal heart function is restored.

To avoid myocardial hypertrophy and mitigate symptoms, the following are used:

  • vitamins for the heart – provides the supply of all necessary elements to the body;
  • corticotropic hormones – cortisone favorably affects the processes inside the secondary muscle;
  • cocarboxylase hydrochloride – restores heart rate;
  • beta blockers to eliminate some heart diseases.

Often, impaired repolarization becomes a sign of emerging coronary disease, which allows you to take measures to eliminate the danger in advance.

Important! Young people need to regularly check the state of the heart muscle in order to provide medical assistance on time.

In the absence of pathological changes or negative trends, people under 35 should not be very worried, but simply undergo a routine examination regularly.

Sometimes repolarization is the result of hormonal disruption. This is characteristic of the adolescent period, when internal restructuring forces the body to work to the limit. Treatment is either not required or is aimed at eliminating the symptoms. Such repolarization occurs after puberty.

The contraction of the heart is due to electrical impulses that are conducted to each cell of the myocardium (heart muscle). After receiving such an impulse, each cardiomyocyte passes through the stage of contraction and relaxation, which make up the cardiac cycle.

However, behind each of these stages there is a complex mechanism of the flow of calcium, potassium and chlorine ions from and to the cell. The electrical changes in the membranes of cardiomyocytes that underlie contraction are called depolarization, while the underlying changes in relaxation are called repolarization.

Click on the photo to enlarge

When doctors talk about repolarization, they do not mean ion current through the membrane of the heart cells, which is impossible to measure in clinical practice, but about the characteristics of the ECG pattern at the time of ventricular relaxation.

The ECG normally has the form of a curve, which consists of several teeth:

  • P – Displays atrial contraction.
  • Q, R, S – represent ventricular contraction.
  • T – Displays ventricular relaxation.

Between these teeth there are segments and intervals. Violations of the processes of repolarization on the ECG in adults and children are displayed by changes in the ST segment and T wave.

The process of repolarization can be influenced by many factors, including:

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Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.