Violation of the repolarization process is anotherpathology of the cardiovascular system, in particular - the pathology of the conductive and excitable part of the heart tissue. Such changes are characterized primarily by combined changes in the electrocardiogram. Most often, the repolarization disorder manifests itself as a negative (or located at the isoline level) tooth T in the first and second standard leads. The same picture, together with the shift of the ST segment below the isoline, is observed in both the aVL leads and the fifth and sixth thoracic leads.
Often, these signs are characteristic for a dysfunctional disorder of the sympathetic nervous system, that is, for functional cardiopathy.
Such cardiomyopathy manifests itself as a violationthe process of repolarization of the tissues of the heart muscle (myocardium), which can initiate disturbances in the conduction and rhythm of the heart. Violation of the process of repolarization can be caused by a large group of causative (etiological) factors. All these factors were combined into four groups, based on common points in the pathophysiology of the processes. The first group is diseases that lead to a violation of neuroendocrine regulation of the cardiovascular system, including mechanisms of violation of potassium and catecholamine levels of regulation. The second group includes all dystrophic and inflammatory lesions of the muscle tissue of the heart. In addition, disturbance of the repolarization process may be caused by overload or hypertrophy of the myocardium. The latter group includes secondary disorders that result in a broadening of the QRS complex (blockade of the bundle branches, WPW syndrome).
The most frequent violation of the repolarization processdevelops as a result of hypersympathicotonia. This pathology manifests itself in early childhood and is characterized by an increase in the level of hormones (epinephrine and norepinephrine) by half as compared with the norm. In addition, the violation of repolarization processes in the myocardium can be caused not by an elevated level of these hormones in the blood, but by increased sensitivity of the cardiac tissue to catecholamines. As a result, with a normal level of hormones, a complete clinical picture of hypersympathicotonia is observed.
Among the causes of violations in the processesrepolarization of the myocardium, the largest proportion is occupied by the following: coronary heart disease, disturbance of mechanisms and sequence in the depolarization phase, hypertrophy and overstrain of ventricular muscle tissue, disturbances in the electrolyte balance (in particular - disbalance of sodium and potassium balance).
A separate group includes nonspecific causes.In fact, the violation of repolarization of the muscle tissue of the heart in this case occurs without the presence of visible objective reasons. In this case, diagnosis and differential diagnostics do not allow to identify reliable causes of the disease.
Such violations are increasingly found in young peopleof adolescents. Most of these disorders are transient and do not need treatment. However, even in the absence of treatment, the management of such patients requires constant dynamics in the electrocardiography data. Treatment of violations of myocardial repolarization is primarily based on the elimination of the effect of the causative factor, that is, the treatment is etiotropic.
At the heart of its treatment includes a complexmedicines, consisting of corticotropic hormone, anaprilin, panangin, cocarboxylase and vitamin preparations. In any case, during the treatment of this pathology, compulsory dispensary observation of the patient is required.
