Hyperventilation ST Segment Depression

Report:

Sinus arrhythmia 72 -112/min

Anteroseptal ST segment depression

Comment:

One clue that deep breathing may be causing the mid-precordial ST segment depression is the sinus arrhythmia, drifting into a tachycardia range during inspiration. Deep, but not obviously fast; we weren’t here to see why. Non-ischæmic ST depression (including false positive exercise tests) is commoner in women; some have related this to œstrogens having a digoxin-like ring! This is slow-rising variety ST depression, except in lead V4, where it is horizontal. Even the slow-rising type is to be taken seriously if there is 1 mm or more depression 0.08” after the J-junction: it would constitute a positive stress test.

Hyperventilation is a common cause of ST depression; sometimes it is performed prior to stress testing while the subject is still at rest.

116. 49 year old lady with chest pain of 40 minutes’ duration. It eased with nitroglycerin but did not go away.

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Ischaemia

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