Early ventricular repolarization syndrome

The reasons

Kinds

Symptoms of an SRRS

Diagnostics

Treatment of early ventricular repolarization syndrome

Complications and prognosis

Early ventricular repolarization syndrome (SRSR) is a medical concept that includes only ECG changes without characteristic external symptoms. It is believed that SRSR is a variant of the norm and does not pose a threat to the life of the patient.

Recently, however, this syndrome has been treated with caution. It is widely distributed and occurs in 2-8% of cases in healthy people. The older a person becomes, the less chance there is of detecting CRSH in him, this is due to the occurrence of other cardiac problems that are similar in electrocardiographic characteristics as the age increases.

Most often, the syndrome of early repolarization of the ventricles is diagnosed in young men who are actively involved in sports, in sedentary men, and in people with dark skin (Africans, Asians, and Latin Americans).

The reasons

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The exact causes of SRRS are not established to date. However, a number of factors that contribute to the emergence of the syndrome of repolarization are highlighted:

  • taking certain medications, such as A2-adrenergic agonists ( clonidine );
  • familial hyperlipidemia (high fat in the blood);
  • connective tissue dysplasia (individuals with SRSR are more likely to have its symptoms: joint hyper- mobility, spider fingers, mitral valve prolapse ); 
  • hypertrophic cardiomyopathy. 

In addition, this anomaly is often diagnosed in people with congenital and acquired heart defects and in the presence of congenital pathology of the cardiac conduction system.

The genetic nature of the disease is also not excluded (there are certain genes that are responsible for the occurrence of SRRG).

Kinds

There are two options SRRZH:

  • no damage to the cardiovascular and other systems;
  • with the involvement of the cardiovascular and other systems.

From the point of view of the nature of the flow, they distinguish between transient and permanent SRSR

On the localization of ECG signs, doctor A.M. Skorobogaty proposed the following classification:

  • Type 1 – with a predominance of signs in leads V1-V2;
  • Type 2 – with a predominance in leads V4-V6;
  • 3rd type (intermediate) – without the predominance of signs in any leads.

Symptoms of an SRRS

There are no characteristic clinical signs of early ventricular repolarization syndrome. There are only specific changes on the ECG:

  • ST segment changes and T wave;
  • in a number of branches, the ST segment elevation above the isoline by 1-2-3 mm;
  • Often the rise of the ST segment begins after a notch;
  • the ST segment has a rounded shape and directly transforms into a high positive T-wave;
  • the convexity of the ST segment faces down;
  • The base of the T wave is wide.

Diagnostics

Since this syndrome is an electrocardiographic phenomenon, it can only be established with a specific examination:

  • ECG;
  • Heart ultrasound (echocardiography);
  • stress echocardiography (for violation of ventricular contractility)
  • resting echocardiography;
  • Holter monitoring during the day; 
  • electrophysiological study.

In addition, tests are carried out on a bicycle ergometer or treadmill : after exercise, the heart rate rises, and the ECG-signs of SRRZh disappear.  

Use the test with potassium: after taking potassium chloride, panangin or ritmokor not less than 2 grams, the severity of ECG signs of repolarization syndrome increases.

Sample with isoproterenol and atropine is not used due to pronounced side effects.

It is important to distinguish between SRSR and myocardial infarction, pericarditis, Brugada syndrome. For this purpose, carry out differential diagnosis.  

Treatment of early ventricular repolarization syndrome

Specific treatment of the syndrome does not require repolarization . The only thing that is offered to the patient is observation by a cardiologist. 

However, a person with SRRS should eliminate alcohol and intense physical activity, so as not to provoke a tachycardia attack.

In some cases, radiofrequency ablation of the additional beam is performed in an invasive manner (the catheter is brought to the place of the beam and destroys it).

Energy therapy is sometimes used (B vitamins, carnitine, phosphorus and magnesium preparations, Mexidol , Kudesan ), antiarrhythmic drugs (amiodarone).

Important! The patient should maintain all previous ECG that is required to exclude the diagnosis of myocardial infarction in case of pain in the heart.

Complications and prognosis

SRRZh can cause the following complications:

  • sinus bradycardia and tachycardias;
  • atrial fibrillation; 
  • extrasystoles;
  • heart block;
  • paroxysmal tachycardia;
  • coronary heart disease.

Forecast development SRRZh favorable. It is believed that in 28% of cases it increases the risk of death from a cardiac cause, but many researchers assume that the probability of a lethal outcome with SRSR is much lower than with smoking, alcohol abuse and excessive passion for “heavy” food.

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