Violation of the repolarization process is another pathology of the cardiovascular system, in particular, the pathology of the conducting and excitable parts of the heart tissue. Such changes are characterized primarily by combined changes in the electrocardiogram. Most often, repolarization disorder is manifested by a negative (or located at the isoline level) T wave in the first and second standard leads. The same picture, together with the displacement of the ST segment below the contour, is also observed in leads aVL and the fifth and sixth chest leads.
Often, these signs are characteristic of a dysfunctional disorder of the sympathetic nervous system, that is, functional cardiopathy.
Such cardiomyopathy is manifested as a violation of the 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 causal (etiological) factors. All these factors were combined into four groups, based on common points in the pathophysiology of processes. The first group is diseases that lead to a violation of the 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, a violation of the repolarization process can be caused by overload or hypertrophy of the myocardium. The latter group includes secondary disorders leading to the broadening of the QRS complex (blockade of the branches of the bundle of His, WPW syndrome).
Most often, a violation of the repolarization process develops as a result of hypersympathicotonia. This pathology manifests itself in early childhood and is characterized by a two-fold increase in the level of hormones (adrenaline and norepinephrine) compared to the norm. In addition, the violation of the processes of repolarization in the myocardium can be caused not by an increased level of these hormones in the blood, but by an increased sensitivity of the heart tissue to catecholamines. As a result, with a normal level of hormones, a complete pronounced clinical picture of hypersympathicotonia is observed.
Among the causes of disturbances in the processes of myocardial repolarization, the following occupy the largest share: coronary heart disease, violation of mechanisms and sequences in the depolarization phase, hypertrophy and overstrain of the muscle tissue of the ventricles, disturbances in the electrolyte balance (in particular, imbalances in sodium and potassium balance).
A separate group includes non-specific causes. In fact, violation of the repolarization of the muscle tissue of the heart in this case occurs without the presence of obvious objective reasons. In this case, the diagnosis and differential diagnosis do not reveal reliable reasons for the development of the disease.
Such disorders are increasingly found in young adolescents. Most of these disorders are transient and do not need treatment. However, even if untreated, the management of such patients requires constant dynamics in electrocardiography data. The treatment of myocardial repolarization disorders is primarily based on the elimination of the causative factor, that is, the treatment is etiotropic in nature.
At its core, treatment includes a complex of drugs consisting of corticotropic hormone, anaprilin, panangin, cocarboxylase and vitamin preparations. In any case, during the treatment of this pathology, mandatory follow- up observation of the patient is required.