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Chapter 11: THE RESTING ELECTROCARDIOGRAM NONSPECIFIC ST-SEGMENT-T-WAVE CHANGES
While it seems more appropriate to discuss ST-segment and T-wave changes separately, they will be dealt with together because of their often coexistence. While nonspecific (or rather, nondiagnostic) ST-segment-T-wave changes are the most commonly diagnosed ECG abnormalities, they have not been categorized adequately and represent different findings for various interpreters.45 In the classic paper, Friedberg and Zager46 considered depth of ST-segment depression and T-wave inversion as well as their contour (Fig. 11-6).46 When analyzed without clinical information, this diagnosis was made in 40 percent of 410 abnormal ECGs. The number was reduced to 10 percent, however, when clinical data became available. In the absence of structural heart disease, these changes can be due to a variety of physiologic (i.e., hyperventilation, anxiety, body position, food, neurogenic influences, and temperature), pharmacologic (i.e., antiarrhythmic and psychotropic drugs, digoxin), and extracardiac (i.e., electrolyte abnormalities, upper gastrointestinal processes, allergic reactions, etc.) factors.45
Hurst's the Heart; Chapter 11: THE RESTING ELECTROCARDIOGRAM. Page 11
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