Moderate disturbance of left ventricular repolarization processes

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.

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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, recent scientific research suggests 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.
  • 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.

Normal indicators and causes of changes

Myocardial hypoxia is a consequence of circulatory and respiratory disorders. Changes in the repolarization phase act as early signs of hypoxia, since the cell membrane is very sensitive to changes in the state of potassium and sodium ions. The stage of repolarization can be called a process that requires a supply of energy.

It enters the cells in the form of adenosine triphosphoric acid molecules, for the synthesis of which oxygen is needed. When myocardial ischemia occurs, changes in the repolarization phase will occur first. Severe hypoxia will cause a different type of arrhythmia and adversely affect the heart rate.

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However, ischemia is a reversible process, and after some time the metabolism in the cells is restored. This means that the dynamics of changes will be visible on the electrocardiogram. Assessing the data obtained in conjunction with the clinical picture, you can make the correct diagnosis.

Diffuse hypoxic states of a certain duration can cause only changes in the size of the T wave. A similar situation will occur with various metabolic disorders, not only in the myocardium, chronic anemia, etc.

All conditions that change the content of basic cellular ions also affect the processes of repolarization. Violation of the electrolyte balance of the cells will entail various changes in both the ST segment and the T wave.

Violations noted in the phase of repolarization are non-specific, are detected by chance, showing nothing else. Similar situations are not uncommon among adolescents and young people (often among athletes). This is the so-called phenomenon of early repolarization. Conducted drug tests in this case, which give a positive trend, speak about the functional (metabolic) genesis of disorders in this phase.

A common cause of diffuse disorders is an increase in the tone of the autonomic nervous system, namely its sympathetic division. Hormonal influences significantly affect the discussed processes of cell membrane restoration.

When fixing such changes on the electrocardiogram, it is always necessary to carry out differential diagnostics with various acute disorders in order to start timely and adequate therapy.

Acute pericarditis on the electrocardiogram has a very similar picture of changes with repolarization disorders. And only observation in dynamics can finally dispel doubts.

There is only one conclusion: to confirm the diagnosis, additional research methods are necessary. The complexity of the interpretation of the electrocardiographic curve is largely due to the heterogeneous nature of the bioelectric processes and requires the doctor to study the clinical status of the patient.

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One of the serious pathologies that leads to such disorders is hypersympathicotonia. This disease has been affected since childhood. A feature of this disease is the presence of a high level of adrenaline in the blood.

Constant hard work and various stressful situations can also be the causes of the problem under discussion. The same risk factor exists for pregnant women and for menopausal women. Any imbalance of hormones in the human body causes disturbances that will be reflected on the ECG and manifest themselves with certain symptoms.

Pathological repolarization disorders provoke changes in the ECG curve of the height of the T wave. However, it is impossible to make a precise diagnosis – this phenomenon is observed not only with heart diseases, but also with any metabolic disorders. If the shift of the ST segment is also traced, this indicates a violation of the electrolyte balance in the cells. The process of repolarization can be disrupted by a serious pathology – hypersympathicotonia, accompanied by an increase in the level of adrenaline in the blood.

narproc repoljarizacii 3 - Moderate disturbance of left ventricular repolarization processes

Many people have pathological changes in the lower wall of the heart muscle, completely unaware of it – such processes cause heavy physical labor, constant stressful situations, hormonal disorders and aging of the body

This condition is caused by an increase in the tone of the sympathetic part of the autonomic system and causes:

  • decrease in sweating, secretion of saliva and mucus;
  • dry skin;
  • tachycardia;
  • pain in the heart;
  • noticeable change in mood;
  • increase in blood pressure.

The human heart is an amazing organ whose conducting system constantly produces impulses that trigger its contraction. The heart works “tirelessly.” But sometimes myocardial repolarization processes may be disturbed – we will talk about this in more detail.

Action potential of the heart cell

In fact, it’s not worth going to the very back of the heart electrophysiology. It is important to understand the basic principles of the electrical work of the heart.

The muscle membrane of the heart or myocardium can be in an excited state and at rest.

Having reached the muscle cell, the impulse transfers the cells of the heart muscle from the resting state to the state of excitation (depolarization) through a chain of biochemical reactions.

Due to this, the chambers of the heart contract, expelling oxygen-enriched blood to the great vessels and providing tissues and organs with it.

After a pulse run, the excited membrane acquires its former charge, passing into the resting phase. Such a phase change allows not only the conductive system, but also the entire myocardium to prepare for the next reduction without loss.

However, sometimes for certain reasons, there may be a violation of myocardial repolarization.

Causes of impaired repolarization processes in childhood

Similar changes in the cardiogram can be not only in an adult, but also in a child. Not always the presence of such changes indicates a pathology of the cardiovascular system.

What could be the reason for the violation of repolarization processes in childhood? Two main groups of causes can be distinguished. The first group is functional in nature.

Very often, the intensive growth of the child’s body and an increase in physical exertion, emotional upheaval and other factors lead to an inadequate response of the cardiovascular system.

A number of diseases that affect the electrophysiological state of the myocardium can be the cause of ventricular repolarization disorders. Not always these diseases affect the cardiovascular system, other organs and systems may be involved.

Possible causes may include thyrotoxicosis, decreased thyroid function, anemia, chronic tonsillitis, inflammation of the heart muscle, neurocirculatory dystonia, cytostatic drugs, glucorticosteroids, non-steroidal anti-inflammatory drugs, pneumonia, bronchial asthma, etc.

IHD as a cause of ventricular myocardial repolarization processes

In young patients, as well as people of middle, old and senile age, a violation of the processes of ventricular myocardial repolarization can be caused by coronary heart disease, left ventricular myocardial hypertrophy, arterial hypertension, congenital and acquired heart defects, neurocirculatory dystonia, chronic pathology of ENT organs, electrolyte disturbances, taking medications, menopause, etc. The clinical manifestation will depend on the underlying disease.

Quite often, patients may not complain. During pregnancy, such changes in the cardiogram may be recorded. As a rule, these changes are not diffuse, but local.

Clinically, a violation of the repolarization processes in pregnant women may not manifest itself in any way.

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An increase in the volume of the vascular bed and the volume of circulating blood during pregnancy are characterized by certain changes in the ECG, which should not be forgotten before rushing into a panic.

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4 Diagnostics

ECG of the heart. Impaired myocardial repolarization

Violation of ventricular myocardial repolarization is not a diagnosis, but just a conclusion that the doctor of functional diagnostics leaves on an electrocardiogram. The ECG conclusion only supplements the complex of diagnostic measures.

ECG signs of impaired repolarization processes is a change in the ST segment and T wave.

Unlike the syndrome of early repolarization, they are nonspecific in nature and can be observed in a number of diseases not only of the cardiovascular, but also of other systems.

These changes can be diffuse or local in nature, affecting the anterior, posterior, lower, lateral wall or a specific area of ​​the heart. During pregnancy, a decrease in the ST segment to 0,5 mm below and 1-3 mm above the contour is acceptable.

The T wave in most patients becomes negative, smoothed, or biphasic.

In the chest leads, a gradual decrease in the amplitude of the T wave by the end of pregnancy can be observed, which is not a pathological sign.

In middle-aged and older patients with impaired myocardial repolarization, a diagnostic search, as a rule, is aimed at identifying possible cardiovascular pathology.

Therefore, an electrocardiographic study can be supplemented by a number of instrumental and laboratory methods necessary for a specialist to make a diagnosis.

5 Treatment

Seeing such a conclusion on the ECG, do not rush into a panic and think up all kinds of scary stories. This still does not mean anything. It’s worth starting with your doctor and starting to dot all the “and”.

Identification and elimination of the cause can lead to the fact that the ECG of both a child and an adult returns to normal. It is not the ECG that needs to be treated, but the patient. First of all, you need to find the root cause and try to eliminate it.

What is “depolarization” and “repolarization”

The occurrence of an impulse (electric current or action potential) in the cells of the heart goes through two main periods:

  • Depolarization – sodium and calcium ions enter the cell and the charge changes to positive. With a certain speed, the depolarization wave is transmitted to neighboring cells and covers the entire muscle. Actin combines with myosin and the heart contracts. The wave propagation speed depends on the presence of healthy or altered cells (ischemic or scar tissue) on the path of the pulse.
  • Myocardial repolarization is a longer period, it is necessary to restore the negative intracellular charge, the flow of potassium ions should leave the cells. This phase determines the accumulation of energy in the muscle of the heart and preparation for the next contraction. Visible rest actually includes all the biochemical mechanisms of energy production, enzymes and oxygen from the blood are wasted. Until complete recovery is complete, the heart cannot contract.

The most important mechanism providing sufficient action potential is the sodium-potassium pump.

Violation of myocardial repolarization can be detected by electrocardiographic examination to determine the time of repolarization.

How to correct repolarization deviations?

Not a single doctor makes a diagnosis or prescribes treatment only by the results of electrocardiography! For this purpose, anamnesis data and a complete clinical picture of the patient’s pathological condition are collected, additional studies are performed: echocardiography, ultrasound scanning of the heart, functional stress tests.

It is difficult to unambiguously interpret the final data of the ECG curve – this is due to the heterogeneous nature of bioelectric processes. After conducting a comprehensive examination and establishing an accurate diagnosis, a qualified cardiologist prescribes a course of therapeutic measures aimed at eliminating the etiological causes of pathological changes.

  • regularly monitor the ECG;
  • eat rationally;
  • to carry out activities aimed at strengthening the state of health of the body and preventing the formation of pathological processes;
  • comply with the recommendations of the attending physician about the possibility of physical activity;
  • constantly take vitamins and prescribed medications.

The prognosis of the course of heart diseases when the patient fulfills all the instructions of an experienced specialist is completely favorable. The presence of deaths of close relatives from sudden cardiac arrest is very important – this phenomenon significantly complicates the prognosis. The absence of a burdened family history has a more favorable meaning.

  • Pathological changes in the T wave;
  • ST segment deviation from the contour;
  • Violation of the indicators of the QRS complex (normal Q and S teeth are negative, and R wave is positive);
  • P wave change

The ECG syndrome of early repolarization of the ventricles of the heart is characterized by some specific abnormalities:

  • the ST segment begins to rise from point J;
  • T wave narrow, significant violation of symmetry;
  • nicks or other changes occur in the lower part of the R wave;
  • an upward concavity is formed in the interval of the ST segment.

Not a single doctor makes a diagnosis or prescribes treatment only by the results of electrocardiography! For this purpose, anamnesis data and a complete clinical picture of the patient’s pathological condition are collected, additional studies are performed: echocardiography, ultrasound scanning of the heart, functional stress tests.

It is difficult to unambiguously interpret the final data of the ECG curve – this is due to the heterogeneous nature of bioelectric processes. After conducting a comprehensive examination and establishing an accurate diagnosis, a qualified cardiologist prescribes a course of therapeutic measures aimed at eliminating the etiological causes of pathological changes.

The prognosis of the course of heart diseases when the patient fulfills all the instructions of an experienced specialist is completely favorable. The presence of deaths of close relatives from sudden cardiac arrest is very important – this phenomenon significantly complicates the prognosis. The absence of a burdened family history has a more favorable meaning.

The main and only method for the diagnosis of ventricular repolarization disorders is electrocardiography. On the film, nonspecific changes of the T wave (mainly in the chest leads) are visible – it becomes high, pointed, or, conversely, its amplitude decreases, it can be negative.

Of much greater interest is the ECG diagnosis of SRGR, in which the following main signs are noted:

  • ST segment lift;
  • point j, “camel hump”, “Osborne wave” – notch on the descending part of the ST segment;

Shortening of the PQ and QT intervals may also be observed.

Decoding a cardiogram requires special care from a doctor, since an ST segment elevation occurs in other, more serious pathologies, such as angina pectoris, myocardial infarction, pericarditis, etc. Most often, the clinical picture does not help in differential diagnosis, because Anemia is not accompanied by any symptoms.

However, if I find the above changes on the film in an adult (especially after 40 years), then I additionally prescribe stress tests, i.e. ECG removal at a time when the patient performs moderate physical activity – on a bicycle ergometer or treadmill (treadmill). With ATS, the cardiogram returns to normal. This helps me make a differential diagnosis with a painless form of angina pectoris and heart attack.

In the case of an uncertain ECG picture, I use special tests with drugs. The patient is injected with potassium chloride or Novocainamide. After 30 minutes, the ECG is removed. With ATS, the symptoms become more distinct.

To detect possible arrhythmias, I conduct my patients daily (Holter) ECG monitoring.

Since ATS can develop amid organic heart diseases, I prescribe echocardiography to assess the morphological structure of the myocardium.


To diagnose the correct processes of depolarization and repolarization, electrocardiography of the heart (ECG) is used.

The teeth and intervals do not tell the layman anything. Functional diagnostics doctors are familiar with the subtle signs and changes of characteristic teeth, and can calculate the repolarization time.

An increase in the time of depolarization of the ventricles of the heart indicates a mechanical obstacle to the propagation of the pulse. This is possible with blockades of varying degrees. An acute heart attack most often affects the left ventricle. Here a connective tissue scar is formed, which serves as an obstacle to the impulse. In conclusion of the ECG, the doctor, in addition to signs of a heart attack, will write about a moderate violation of depolarization.

The impaired repolarization is indicated by a decrease in the T wave. This is characteristic of diffuse dystrophic changes, cardiosclerosis. In this case, the conclusion of the ECG does not make a diagnosis, but helps to understand the mechanism of the formation of symptoms of the disease, stage and form.

Myocardial hypertrophy is impaired by taking certain medications, a lack of trace elements and vitamins in the diet, and dehydration of the body. Such a patient should be examined in a hospital, conduct a stress test with potassium chloride. After the introduction of potassium on the ECG, the normalization of the shape of the ventricular complexes is recorded.

The presence of repolarization disorders is determined by the ECG according to characteristic changes in the ST segment and T wave. These changes can be observed in all or part of the ECG leads. Sometimes they can be used to judge the causes of these violations, and sometimes not. For additional verification of the diagnosis, doctors prescribe examinations:

  • Laboratory blood tests to detect inflammatory diseases, metabolic and electrolyte problems.
  • Echocardiography is an ultrasound examination of the heart, allowing to reveal its structural changes and impaired myocardial contractility.
  • Coronarography is a study of patency of the coronary arteries supplying the heart.

In addition to the electrocardiogram and to diagnose a violation of the processes of repolarization, the cardiologist may prescribe other studies:

  • Functional pharmacological tests (most often, potassium chloride and anaprilin).
  • Echocardiography.
  • Ultrasound examinations.
  • Samples with physical activity.
  • Hormonal status research

Since diffuse repolarization disorders do not differ in the specific clinical picture, a thorough diagnosis is necessary to clarify the diagnosis. First of all, a cardiologist:

  • ascertains the nature of the current clinical picture – what symptoms appear, their duration, frequency;
  • collects personal and family history;
  • examines the patient’s medical history;
  • ascertains whether the patient is taking any medications without a doctor’s prescription.

In addition, they carry out such diagnostic measures as:

  • general and biochemical blood test;
  • ECG;
  • coronary angiography;
  • echocardioscopy;
  • chest x-ray;
  • blood test for hormones.

Based on the diagnostic results, the doctor determines the cause of the onset of symptoms, the nature of the pathological process and treatment tactics that will help eliminate the violation of repolarization in the ventricular myocardium. The course of basic therapy will be aimed primarily at eliminating the root cause factor. If cardiac pathology is established, then a pacemaker is set for the patient.

  • nitrates;
  • diuretic;
  • antihypertensives;
  • to stabilize blood pressure.

The appointment of drugs is carried out strictly on an individual basis. It is strongly not recommended to take them on your own or make adjustments to the scheme prescribed by a doctor. In addition to directly directed against the pathology of medical measures, you should adhere to the general recommendations:

  • limit yourself to physical activity;
  • quit smoking and excessive drinking;
  • Healthy food;
  • avoid stress and nervous experiences;
  • control your blood pressure;
  • take daily walks in the fresh air.

Subject to all doctor’s recommendations, serious complications can be avoided and cardiac performance can be stabilized. If isolated, that is, without cardiac pathology, impaired repolarization processes is diagnosed, the prognosis is favorable. In other cases, everything will depend on what caused the development of the pathology.

Violation of repolarization processes

Violation of the processes of repolarization – the main symptoms:

  • Headache
  • Weakness
  • Dizziness
  • Increased temperature
  • Cardiopalmus
  • Dyspnea
  • Memory impairment
  • Heart rhythm disturbance
  • Rapid pulse
  • High blood pressure
  • Malaise
  • Pallor of the skin
  • Tingling in the heart
  • Blood pressure fluctuations
  • General worsening
  • Slow heartbeat

Violation of the processes of repolarization is a disease during which the phase of repolarization shortens or becomes longer in time. Such a violation can be symptomatic, but this can only be determined by conducting the necessary diagnostic measures.

Diffuse disorders of repolarization of the heart are changes that are clearly visible on the cardiogram. They can occur in the elderly as a marker of cell involution or in people of all ages as a marker of external effects on the heart.

Danger state

Diffuse disorders of the processes of repolarization in the myocardium are dangerous because there is a high probability of an additional reduction before the end of the process of repolarization.

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Clinically, this is manifested by the appearance of extrasystoles (in the best case, supraventricular, in the worst – ventricular).

In severe cases, polymorphic polytopic ventricular tachycardia can develop, which goes into ventricular fibrillation and causes a person to die.

Not always a diffuse violation of the process of repolarization of the heart leads to such complications. Sometimes the condition simply remains an ECG phenomenon that does not affect hemodynamics and does not cause other rhythm disturbances.

Unfortunately, when a doctor sees a person and his electrocardiogram with impaired repolarization, he cannot predict whether this person will have complications or not.

Therefore, it is necessary to constantly be under the supervision of a cardiologist and periodically make new cardiograms.

Reasons for change

Diffuse changes in repolarization processes can occur during the development of the following conditions:

  1. Myocarditis of any etiology.
  2. Cardiomyopathies – hypertrophic, dilated, restrictive.
  3. Coronary heart disease.
  4. Electrolyte imbalance associated with a change in the concentration of potassium, calcium, sodium, chlorine in the body.
  5. The development of metabolic acidosis, or alkalosis.
  6. Respiratory failure with the formation of alkalosis or acidosis.
  7. Severe pulmonary hypertension.
  8. Shock of various etiologies.

Particular attention should be paid to coronary heart disease. It is generally accepted that this disease leads to a heart attack of a local area of ​​the left ventricle. Such a complication is really characteristic of this pathology. However, at the same time, all parts of the heart, and not just separate areas of the left ventricle, suffer from constant ischemia (lack of blood flow and oxygen).

Of course, the degree of tissue ischemia is different – it depends on the degree of narrowing of the coronary arteries and ensuring collateral blood flow. But all cardiomyocytes to one degree or another will suffer from coronary heart disease and in them diffuse repolarization disorders can develop in all of them. Moreover, the severity of such changes will also depend on the degree of ischemia.

To identify changes, you need to record a cardiogram or a series of them. To identify possible complications, it is necessary to conduct Holter monitoring. But to identify the causes of this condition, other diagnostic methods are needed.

  1. Complete blood count – the identification of markers of the infectious process.
  2. A blood test to determine the electrolyte composition.
  3. Echocardiography for assessing the state of the heart chambers.
  4. Dopplerography of the vessels of the heart. If necessary – angiography.
  5. Treadmill test in the department where there is a resuscitation kit.

The latter technique allows you to identify hidden cardiac ischemia and diagnose coronary disease. This method should never be used first, especially if there is at least minimal suspicion of the presence of myocarditis in humans. Incorrect load diagnosis can result in death!

Medical tactic

narproc repoljarizacii 1 - Moderate disturbance of left ventricular repolarization processes

Before proceeding with the treatment of pathology, it is necessary to find out the cause of the condition and, as soon as possible, eliminate it. Otherwise, all therapeutic measures will be ineffective.

If you identify the cause at the initial stage and quickly eliminate it – there is a chance that the diffuse violation of the repolarization process will disappear.

If the cause is eliminated, and the changes remain, it is necessary to use special cardioprotective drugs.

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.
  • Pallor of the skin
  • Headache
  • Dizziness
  • Slow heartbeat
  • Blood pressure fluctuations
  • Memory impairment
  • Heart rhythm disturbance
  • Malaise
  • Dyspnea
  • Increased temperature
  • Tingling in the heart
  • Weakness
  • General worsening
  • Cardiopalmus
  • Rapid pulse

What Repolarization Is

The syndrome of early myocardial repolarization is characterized by the constancy of the ECG picture. In adults, it is necessary to conduct differential diagnosis with acute heart attack. A typical sign is the elimination of signs after a test with physical activity (20 squats). This is explained by the arbitrary increase in the rhythm of contractions of the ventricles, which leads to the normalization of the wave of electrical excitation.

When examining children and adolescents, the frequency of detecting metabolic changes in the myocardium increases. The child does not detect any organic diseases of the heart and blood vessels. Significance in such cases is given to energy disorders.

The causes of early repolarization in children, according to scientists, are associated with impaired development at the embryo stage. The culprit is a mother who during pregnancy did not observe the regimen, did not eat well, and suffered from anemia. Children do not require special treatment, but it is recommended that a cardiologist observe, reduce physical and emotional stress, and proper nutrition.

Similar changes are characteristic for athletes, persons who have undergone hypothermia. Some cardiologists prove the hereditary nature of changes in the conduction system of the heart.

Syndrome of early myocardial repolarization does not have any particular symptomatic manifestations. It can be found both in a perfectly healthy person, and in someone who has some kind of deviation in the work of the heart and system.

Given that the disease can manifest itself in anyone, it is difficult to single out the causes that affect the process of deviation from the norm. Therefore, unfortunately, at the moment there are no reliable recommendations. However, it has been established that the main risks are:

  1. the use of pharmacological preparations;
  2. physical plan reboots;
  3. left ventricular myocardial hypertrophy;
  4. deviations in the work of the cardiovascular system;
  5. electrolyte metabolic disturbances;
  6. a number of environmental influences.

The main way to detect deviations in left ventricular myocardial repolarization is an ECG, and most likely, when undergoing a routine examination.

One of the forms of these disorders is the syndrome of early repolarization of the ventricles (ATS) – an ECG variant observed in 2–5% of the population, more common in men, young people, adolescents, and athletes. Not so long ago we thought that this syndrome has a completely favorable prognosis, that is, it does not affect the health and life of a person in any way. However, it was later discovered that some of its forms increase the risk of developing dangerous arrhythmias and cardiac arrest. This risk can be assessed by ECG.

Repolarization disorders are not an independent disease that has its own symptoms. These are changes on the ECG characteristic of a particular disease. A person can live a long life without even knowing about the existence of an altered ECG, without experiencing any symptoms. Therefore, the clinical picture of repolarization disorder can either be completely absent (for example, with ATS), or it can be very bright (for example, with a heart attack).

There are no individual symptoms that suggest their existence. In the absence of clinical symptoms, this problem is most often detected by chance during electrocardiography. If changes in the ECG have arisen due to any disease, you need to understand that the clinical picture is caused by it, and not by non-specific changes in the ECG.

The heart has three working phases of muscle functioning – excitement, contraction, relaxation. These steps are clearly tracked on the electrocardiogram. Repolarization is the end of the excitation process, the restoration of the membrane potential to its original state. At the same time, the electric charge is stabilized. At this point, the muscle should be in a calm state.

The violation of repolarization on the ECG is determined. Decoding of the graph is individual. Various factors are taken into account. In violation of repolarization, several indicators change. Some of them are not very important, but some deviations are important for making the correct diagnosis.

With repolarization, the heart muscle should be in a calm state. On the electrocardiogram, this is displayed in the QT segment. The norm of the duration of the process is from 0,3 to 0,4 seconds.

When decoding an ECG, it is very important to pay attention to pathologies such as repolarization

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If the values ​​change, this indicates a violation of repolarization. To make an accurate diagnosis, the tooth shapes, waves (or their absence) on the QT segment and general information are additionally deciphered. Normal values ​​are shown in the table.

Indicators Norm
Battlements· T. VR is a negative value, the direction is up. The location of this tooth in relation to others is considered primarily to determine repolarization deviations. · Q – 1/4 R at 0 s. · R – is determined on all leads. In the absence of indicators, ventricular hypertrophy is possible. · S – 3 mm, the ST segment is very important in decoding. · P – a positive indicator in the 20st, 1nd lead. The normal value is 2 s. VR is negative.
IntervalsQT – up to 0,4 s; PQ – 0,12 s; RR – 0,62-0,66-0,6; QRS – up to 0,1 s.
Overview· Heart rate from 60 to 85 beats/min; · Sinus rhythm; · The electrical axis of the heart does not deviate in any direction.

If a person has symptoms of a certain disease or it is already diagnosed, then the attention during decoding is concentrated on changes in certain indicators (duration of intervals, teeth).

When decoding, the doctor should look at the distance between the cloves

In children, repolarization disorders often occur due to heart defects, rheumatic cardiomyopathy, and viral myocarditis. The cause may be additional chords or connective tissue dysplasia. Violation of repolarization processes on the ECG in a child looks like a change in the ST segment and the U and T waves.

The norms and deviations on the cardiogram in babies are identical to adults. The difference is only in the amplitude of the teeth and their length, intervals. It depends on the age of the child.

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Deviations can provoke reasons that do not require treatment. Also, indicators may vary due to serious illness. In this case, treatment is sometimes vital.

Low blood pressure may be one of the reasons for this pathology.

The most common causes of deviations in repolarization are shown in the table.

Nonspecific factors Diseases
• stress; • heavy workload; • abuse of drugs that negatively affect the work of the heart.• ventricular hypertrophy or overexertion; • hypertension; • hypersympathicotonia; • ischemia; • cardiosclerosis; • tissue inflammation; • CNS disorders; • tumors that interfere with the functioning of adrenaline receptors; • dehydration; • impaired renal function; • impaired normal functioning of the neuroendocrine system.• sensitivity of cardiac tissues to nora- and adrenaline (with an increase in their concentration); • imbalance of electrolytes; • deviations in the depolarization sequence; • blockage of the His bundle.

Violations can be associated with oxygen starvation, a decrease in blood pressure, a change in systolic blood pressure in the ventricles. Also, pregnancy and a menstrual pause can be the reasons. Changing the teeth causes any increased load and some factors of vital activity (for example, a change in body position, the use of very cold water).

Physical activity also causes problems in some cases.

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One of the possible deviations is hypoxia, which occurs due to respiratory and circulatory disorders. Changes in repolarization are among the first signs of the disease. For energy storage, synthesis of adenosine triphosphoric acid is required, and oxygen is required, which does not enter in the right amount.

Ischemia appears and the first sign will be a violation of the repolarization processes on the ECG. Pronounced hypoxia causes arrhythmias and affects heart rate. Ischemia is a reversible process. An electrocardiogram shows all the changes, which will allow the doctor to make an accurate diagnosis.

Hypoxic diffuse states vary in duration, cause changes in the teeth, and appear in certain disorders – with constant anemia, myocarditis and other metabolic disorders. Repolarization is affected by conditions affecting cellular ions. Violation of the cellular electrolyte balance entails various changes – in the teeth, segment, etc.

Conditions such as hypoxia and oxygen starvation negatively affect ECG

Deviations in the process of repolarization are sometimes nonspecific. They are asymptomatic and come to light absolutely by accident. Basically, such cases occur in adolescents, athletes. This phenomenon is called early repolarization.

Often diffuse deviations appear against the background of central nervous system overload. Hormonal changes greatly affect the restoration of membranes. All these deviations can be seen on the graph of the electrocardiogram and for the diagnosis will require another differentiated examination.

Acute pericarditis on an ECG presents a picture similar to repolarization disorder. To verify this, it is necessary to trace the dynamics.

One of the most serious pathologies leading to deviations in repolarization is hypersympathicotonia.

Causes of violation

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

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.
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Violation of the process of repolarization of the heart muscle is associated with one of three conditions:

  • QT interval increase;
  • QT interval reduction;
  • Syndrome of early repolarization of the heart ventricles.

Let us consider each of them in more detail.

  • change in the frequency of contractions of the heart muscle (tachycardia, bradycardia);
  • chest pains;
  • arrhythmia;
  • frequent and abrupt mood swings;
  • feeling tired, depressed.

Such symptoms make it possible to suspect an early ventricular repolarization syndrome. Many experts consider this condition a variant of the norm.


Due to the fact that the patient does not have any strictly specific complaints specific to repolarization disorders, the diagnosis is established on the basis of an electrocardiogram.

Therefore, the main diagnostic method is ECG and its variations – daily monitoring of the ECG, ECG after exercise, sometimes – transesophageal ECG.

28973495c3121346b038573e794506d5 - Moderate disturbance of left ventricular repolarization processes

The main criteria on the cardiogram are the following signs:

  • The presence of a small R wave in the ventricular complex QRST,
  • The presence of oblique elevation (ST segment elevation),
  • Change in the T wave – it becomes narrow, asymmetric and even negative, as with ischemic changes.

Such changes are most characteristic of the syndrome of early repolarization of the ventricles (ATS), which is often found in children, adolescents, young people and athletes. This syndrome is one of the variants of violation of repolarization processes.

classic version of changes in SRGR

Other options for impaired repolarization processes are QT shortening syndrome and QT lengthening syndrome. The last two syndromes should not be confused with shortened PQ syndrome, since these are completely different types of heart rhythm disturbances.

The shortened QT syndrome manifests itself on the cardiogram by reducing the duration of the QT interval to less than 0. 33-0.

35 s, and QT lengthening syndrome – an increase in the interval duration of more than 0. 47-0.

When considering pathology, the treatment prescribed by cardiologists directly depends on the root cause, which became the factor that provoked the violation. If it was possible to identify it, the main task becomes its elimination with subsequent re-diagnosis of disorders after the course of treatment.

In cases where the cause as such cannot be identified, therapy is carried out in the following areas:

  • the use of vitamins that will support the normal functioning of the heart;
  • hormones based on cortisone, which beneficially affect all processes in the body, including the work of the heart;
  • Panangin and Anaprilin are used to treat many heart diseases, medicines belong to the group of beta-blockers.

Before choosing a dosage, and indeed the drug itself, a cardiologist must carefully analyze all the results of the studies and evaluate the general state of health.

Medication is usually prescribed only in case of a real threat to life or irreversible heart changes. In the early stages of adults, the disease is treated with vitamins to maintain and normalize the functioning of the heart muscle.

Beta blockers are used in extreme cases. .

The question of the need for treatment of disorders of repolarization processes should be resolved as soon as possible after detecting them on the cardiogram and further examination of the patient.

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In the absence of a causal cardiac pathology, the patient is prescribed drugs or a pacemaker is established based on the presence or absence of clinical manifestations of tachyarrhythmias (fainting, tachycardia, heart failure).

For the smooth functioning of body systems, a number of conditions are necessary. One of them is the lack of cardiological disorders. When exposed to a number of unfavorable factors, a cardiac pathology, called a violation of myocardial repolarization, can develop.

Repolarization is one of the cyclic phases of the functioning of the heart muscle (myocardium), accompanied by the restoration of the electric membrane charge.

  • Coronary heart disease.
  • Thickening (hypertrophy) of the heart.
  • Overexertion of the heart ventricles.
  • The presence of additional ventricular chords.
  • Electrolyte (calcium, potassium, magnesium) imbalance.
  • Hypersympathicotonia (disorders related to the processes of repolarization in the myocardium are explained by an increased concentration of norepinephrine, adrenaline, tissue hypersensitivity to hormones).
  • Cardiomyopathy.
  • Abuse of medications (taking medications not prescribed by a doctor, exceeding the prescribed dosage).
  • Regular drinking.
  • Complications of diseases of the neuroendocrine system involved in the regulation of vital functions of the heart and blood vessels.
  • Hormonal disruptions.
  • Impaired thyroid function, diabetes, and other diseases affecting the endocrine system.
  • Severe menopause, pregnancy. During pregnancy, the cardiovascular (as well as others) body system is susceptible to the effects of negative factors, therefore, with the first symptoms of impaired repolarization processes in the myocardium, you should consult your doctor.
  • Staying in a state of chronic stress.
  • Intense physical exertion, professional sports activities.
  • Negative effects of exposure to low temperatures.
  • Age factors.
  • Heart defects (congenital, acquired).
  • Tumor diseases.
  • Stroke.
  • Traumatic brain injuries.
  • Hereditary predisposition to cardiovascular disease.
  • 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).

The value of the electrical potentials of cell membranes

Impulse transmission in the heart muscle follows a certain path, causing excitation and contraction of myocardial cells. In other words, the processes of depolarization and repolarization are continuously going on in the heart.

Myocardial repolarization is defined as the process of cell repair after contraction. In this period, the charge of the cell membrane returns to its previous state, the electrolyte balance returns to normal, the cells accumulate energy by consuming oxygen. And only after the end of this period of time the heart will be ready for the next contraction.

Even from such a difficult definition, we can conclude how important and vulnerable is the mechanism for restoring the ionic equilibrium of cells.

Violations in this period are detected by registering an electrocardiogram.

Violation of repolarization processes: causes and treatment

Given the above definition of this process, its importance becomes clear. Failures in the operation of such a system can cause a number of complications and malfunctions in the operation of our motor, which is fraught with very serious consequences. One of these problems is a deviation in the rhythm of the heartbeat. As a result, this is a lack of blood supply to organs and a general deterioration in well-being. However, it is worth clarifying that often such a pathological process takes place without visible and tangible consequences.

819647b7e1db293a48e41a3776c75258 - Moderate disturbance of left ventricular repolarization processes

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

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

  • excitation;
  • muscle contraction;
  • relaxation.

Violation of the processes of repolarization in the myocardium can occur just at the stage of excitation. This stage is divided into two stages:

  • depolarization is the beginning when the muscle is actively “working”;
  • repolarization – the end of the phase – the cell “rests”.

Normally, the repolarization process lasts 0,3-0,4 seconds. If there is a steady deviation from this norm, then there is a violation of the process of repolarization in the myocardium of the ventricles. This problem is not always independent, since it is preceded by certain etiological factors. In children, a violation of myocardial repolarization can be caused by congenital diseases and not only with respect to the cardiovascular system.

  • myocardial ischemia;
  • myocarditis;
  • a history of myocardial infarction;
  • cardiomyopathy;
  • arterial hypertension, hypertension;
  • congenital disease – SRH (early ventricular repolarization syndrome);
  • left ventricular hypertrophy;
  • malfunctioning of adrenaline receptors;
  • disturbances in the hormonal background;
  • diseases of the central nervous system;
  • taking some “heavy” drugs – hormones, antibiotics, steroids, sedatives.

In addition, there are a number of predisposing factors that, in the presence of the above pathologies, can provoke a violation of repolarization processes:

  • electrolyte imbalance;
  • debilitating physical activity;
  • frequent stresses, nervous experiences, being in a negative psycho-emotional environment;
  • hypothermia;
  • reception of adrenostimulants.

It should be noted that people with SRH of ventricular repolarization are at risk, as they develop cardiovascular diseases much more often and there is a greater likelihood of sudden cardiac arrest.

Schedule an appointment

What exactly caused the violation of myocardial repolarization is not precisely determined today. Numerous studies have identified several reasons that can cause a change in the processes of myocardial repolarization:

  • the presence of diseases of the heart muscle, in particular, overstrain of the tissues of the ventricles, ischemia, electrolyte imbalance, hypertrophy;
  • the negative effect of medications when they are uncontrolled;
  • increased levels of hormones (adrenaline and norepinephrine) and sensitivity to heart tissue;
  • non-specific reasons. Stress, strong physical exertion, a general change in hormonal levels.

Important! This pathology is increasingly being diagnosed in children and adolescents, especially during phases of active growth. In addition, it is often found in pregnant women.

In most cases, failure of the processes of repolarization of the heart muscle does not have pronounced symptoms. Often, the pathology is recorded accidentally during routine examinations or during examinations, to confirm another diagnosis – when conducting a graphical recording of the heart (ECG).

If the violation of repolarization processes occurs in the myocardium as a whole, i.e. diffuse, it provokes a change in blood circulation, which affects the general condition of the body. In this case, symptoms appear that are also characteristic of any other cardiac pathologies:

  • change in heart rate;
  • chest pain;
  • change in emotional state (tearfulness, excessive irritability);
  • fatigue.

08de7e9bcb1a800461e4c07ca616896d - Moderate disturbance of left ventricular repolarization processes

In addition, there are signs that reflect the area of ​​the heart muscle where a violation of repolarization processes is observed. In particular, left ventricular myocardial repolarization is accompanied by a malfunction of the heart rhythm.

The form of this disease, which is often fixed in young people, is the syndrome of early repolarization of the myocardial ventricles. Today it is considered only as an electrocardiographic concept that does not affect the functioning of the heart.

Interesting! Such a phenomenon, according to statistics, is registered in 8% of people, most of whom have excellent health and exercise regularly.

The syndrome of early myocardial repolarization during an ECG is usually displayed as follows:

  • the appearance of additional small teeth in the descending knee of the R wave;
  • the formation of concavity (upward) in the segment of the ST segment, which goes up from point J;
  • narrowness and asymmetry of tooth T.

Interesting! A number of studies have confirmed the hypothesis that patients with confirmed pathology have a higher chance of developing sudden death of the heart muscle, especially if one of the symptoms of the disease is loss of consciousness of cardiac origin.

Get a treatment program

Violation of myocardial repolarization, the treatment of which completely depends on the root cause of the disease and is aimed at eliminating it, is not rarely considered as normal options, especially in young people. For people over the age of 50, this pathology, combined with complaints about the work of the heart muscle and the corresponding history, can be a manifestation of hypertension or coronary artery disease.

If the exact causes of the appearance of violations of repolarization processes in the heart are not established, then complex therapy with the following drugs is carried out:

  • vitamin complexes that will provide the cardiovascular system with the necessary trace elements and vitamins, thereby supporting its full-fledged work;
  • cocarboxylase hydrochloride, which helps restore carbohydrate metabolism and heart function, as well as normalizes trophic processes in the peripheral and central nervous system;
  • hormones of the corticotropic series, the active substance of which is cortisone. Its main function is to stimulate the synthesis of carbohydrates from proteins, which is necessary for the normal functioning of the body as a whole;
  • panangin or anaprilin, which belong to the group of drugs of β-blockers. They are used to treat this disease extremely rarely, only in cases where there is a real threat to the patient’s health.

The selection of drugs and their dosage for each patient is carried out individually, after a detailed study of the results of analyzes and examinations.

Reasons for change

Clinical case

A large number of people have changes in the wall of the heart muscle, but do not even suspect about it. Such violations are detected by chance when registering an electrocardiogram for any reason.

In those cases when an altered repolarization wave covers a significant part of the heart muscle, the clinical manifestations of the syndrome become noticeable and can manifest themselves in the form of:

  • disorders of the general condition, characterized by rapid fatigue, dizziness, weakness;
  • noticeable mood swings;
  • changes in heart rate;
  • the appearance of pain in the heart.

An increase in the manifestation of these symptoms against the background of physical activity is characteristic.

It was proved that with disturbances in the recovery processes in the lower wall of the left ventricle, the patient may experience an increase in blood pressure, a feeling of dizziness, and photopsia. This is possible especially during physical activity. A similar situation is associated with the anatomical features of the areas of the myocardium and in any case should attract attention.

In the elderly, in the presence of concomitant diseases, a violation of the repolarization process can stimulate the development of severe arrhythmias.

Without tackling the problem for a long time, people endanger themselves. All manifestations of the disease that took place after a short rest begin to intensify and acquire the character of severe, sometimes disabling conditions.

If symptoms appear, then only in the event of a violation of repolarization against the background of some kind of cardiac pathology. Then the patient may complain of heart pain, dizziness, increased heart rate, etc.

I am often asked about whether impaired myocardial repolarization is dangerous, especially during pregnancy. No, but it may indicate a cardiac disease.

As for SRRG, for a long time it was considered completely harmless, it was mistaken for a “random find.” However, many years of clinical trials have cast doubt on this.

It turned out that those people who had signs of AGR in the ECG had a very high risk of developing paroxysmal supraventricular tachycardia, atrial fibrillation, and Wolf-Parkinson-White syndrome in the future (after a few years).

Recently, I observed a patient who came to me with complaints of difficulty breathing, aggravated by walking, climbing stairs, and at night. Several years suffering from arterial hypertension. I have not received any treatment. During a general examination, an increase in heart rate up to 126 per minute, high blood pressure up to 150/95 mm RT. Art., swelling of the feet and lower third of the legs, an increase and pain in the liver during palpation.

An ECG was performed. decoding – sinus tachycardia, diffuse disorders of the processes of left ventricular myocardial repolarization, signs of left ventricular hypertrophy. The patient is referred for echocardiography. Holter monitoring did not reveal other pathological abnormalities. The result – hypertrophy and dilatation (expansion) of the left heart, a decrease in the ejection fraction of the left ventricle – 55%.

Clinical diagnosis was made: “Chronic heart failure stage IIB, II functional class according to NYHA. Background disease: Stage III hypertension, grade 2 arterial hypertension. ” Prescribed treatment: limiting salt intake to 3 g per day, Bisoprolol 5 mg 1 time per day, Perindopril 10 mg 1 time per day, Amlodipine 5 mg 1 time per day.

Data Correction

For the full treatment of such disorders, it is necessary to conduct additional examination methods that confirm the diagnosis. Treatment of repolarization disorders should be aimed at eliminating the cause that caused them.

Therapy of patients with diseases of the endocrine system, heart and blood vessels is carried out according to the protocols for these pathologies. In those cases when the combined pathology has a severe course, threatening the development of fatal arrhythmias, a choice in favor of surgical treatment is possible. After a thorough examination, such patients undergo ablation of the pathways in order to eliminate the focus of arrhythmia or implant a pacemaker.

People who have identified changes on the electrocardiogram without the clinical manifestations of the disease should:

  • to be registered at the dispensary;
  • pass tests with physical activity;
  • regularly undergo an ECG examination;
  • lead a healthy lifestyle;
  • take vitamin and other metabolic drugs as prescribed by a doctor.

Healthy people usually do not receive treatment; it is enough to follow the doctor’s recommendations and undergo regular ECG monitoring. In a child, a similar syndrome will disappear with age, provided careful care and monitoring of development.

e9512494440c3fce248fb17872a1497e - Moderate disturbance of left ventricular repolarization processes

A balanced diet, dosed physical activity, and the absence of bad habits will make you forget about such a frightening violation and its consequences.

Thus, the need for monitoring the work of the heart becomes apparent. And this control will cause a person much less inconvenience than his absence.


What is dangerous in this situation is the almost complete absence of symptoms of the disease. Often, repolarization of the left ventricle is detected only during an ECG, for which a person received a referral for a completely different reason.

What can the doctor see on the electrocardiogram, getting the opportunity to make such a diagnosis as a violation of the repolarization processes occurring in the myocardium:

  1. changes in the P wave, indicating the presence of atrial depolarization;
  2. QRS complex will show ventricular myocardial depolarization. On the cardiogram, you can see that Q and S are negative, R is positive. In this case, the last teeth can be several;
  3. the T wave gives information about the features of ventricular repolarization, according to its deviations from the norm, and violations are diagnosed.

From the general picture of the disease, its form is very often distinguished – the syndrome of early myocardial repolarization. This means that all processes of electric charge recovery start earlier than it should be. On the cardiogram, such a change will be displayed as follows:

  • the ST segment begins to rise from point J;
  • in the descending section of the R wave, peculiar notches can be detected;
  • against the rise of ST, concavity is observed. It is directed upwards;
  • T wave is characterized by narrowness and asymmetry.

Of course, there are an order of magnitude more nuances, and only a qualified specialist can read them on the results of an ECG, as well as prescribe an effective treatment.

Features of treatment

If we consider a violation of repolarization, treatment will depend primarily on the cause of these disorders. If it is identified, then the main goal will be its elimination with re-diagnosis after the patient undergoes a course of treatment. If there is no root cause as such, therapy is carried out in the following areas:

  • vitamin preparations – they will support the full-fledged work of the heart, will be able to ensure the intake of all the vitamins and minerals he needs;
  • corticotropic hormones – the main active ingredient is cortisone, which has a beneficial effect on the processes occurring in the body, including the heart;
  • cocarboxylase hydrochloride – helps restore carbohydrate metabolism, improve trophism of the central and peripheral NS, has a beneficial effect on the cardiovascular system;
  • Anaprilin or panangin are drugs from the beta-blocker group. They are used to treat many heart ailments.

Before choosing a drug and its dosage, the doctor will carefully examine the test results, getting a full assessment of the patient’s health status. Only if the violation does pose a threat to health, for example, if the syndrome of early repolarization of the ventricles of the myocardium is diagnosed, the doctor will select the most effective therapy.

Mild abnormalities in the duration of the repolarization phase can be asymptomatic. In some cases, there are non-specific and short-term symptoms: shortness of breath, tingling in the heart after physical exertion. In general, a violation of the repolarization processes is characterized by the following clinical picture:

  • at any time of the day for no apparent reason, a slowdown in heart rhythm may occur;
  • sinus arrhythmia;
  • tachycardia;
  • shortness of breath, rapid pulse, even with slight physical exertion;
  • unstable blood pressure, most often high.

In addition, the symptomatic complex may include symptoms atypical for heart disease:

  • initial stage of acidosis;
  • fever;
  • weakness, malaise;
  • headaches, dizziness;
  • deterioration in cognitive functions, memory problems;
  • general deterioration of health, pallor of the skin.

Due to the fact that the clinical picture is non-specific, in no case should you take any drugs to eliminate symptoms without a doctor’s prescription. This can lead to a sharp deterioration in well-being.

Why does this pathology arise?

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.

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.

Unfortunately, in most cases, no signs and symptoms of the disease are observed in humans. There is also no pain. Therefore, the disease is detected at routine or professional examinations, also with an ECG.

However, if such pathological changes are observed throughout the heart muscle, signs may also appear. They relate primarily to the rhythm of the heart and the general condition of the body, and unusual sensations also appear. This is due to the fact that the whole body ceases to normally receive nutrients due to circulatory disorders. The main symptoms in this case are:

  • changes in the rhythm of the pulse and heart;
  • pain in the heart;
  • significant fatigue;
  • the appearance of a desire to cry and severe irritation.

The main action after decoding the ECG cardiogram is to establish the basic premises that led to this condition. Various diagnostics are carried out and treatment with drugs is prescribed, which include vitamins, corticosteroids, etc.

However, it is worth remembering that pharmacological treatment is not always necessary. Sometimes it’s enough just to normalize your lifestyle, relieve yourself of stress, relax more and eat right.

Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.