What is early ventricular repolarization in children and adults

The discovery and improvement of cardiography in the 20th century, as a method for studying cardiac function, provided doctors with the opportunity to fix the syndrome of early repolarization of the ventricles of the heart. Why is this phenomenon dangerous, if certain symptoms are absent, can it manifest itself in healthy people, but is not a diagnosis in medical language?

Pathogenesis and risk group

The normal rhythm of the heart involves a strict sequence of phases of contraction (depolarization) and relaxation (repolarization). From the atria, in which depolarization occurs, an electrical impulse is transmitted through the atrioventricular node to the ventricles, causing them to contract.

The time interval between atrial and ventricular contractions is 0.1 s, which ensures the stability of blood flow. Then comes the relaxation phase. Early repolarization produces a failure in the process of electrolyte exchange and provokes violations in the conduction of impulses.

From a chemical point of view, charged potassium, sodium and calcium ions from the intercellular space pass into the heart cells (cardiomyocytes) and return back. Minor changes for a long period were considered the norm by cardiologists. In the 2nd half of the 20th century, researchers proved the connection between early ventricular repolarization and the occurrence of various types of arrhythmias, leading to dysfunctions of cardiac activity, up to a possible death.

Pathology in the vast majority is asymptomatic. Rare failures do not pose a significant danger to the work of the heart. The changes revealed on the cardiogram should be analyzed in the process of dynamics.

• professional athletes;
• people engaged in hard physical labor;
• children and adolescents during puberty.

Persons with repolarization syndrome should be under cardiac supervision, since insufficient attention from the patient may ultimately result in a death sentence.

Causes and signs

• long-term use of medications of the group of adrenostimulants;
• increased concentration of body fat;
• abuse of alcohol and toxic substances;
• significant physical exertion and systematic hypothermia of the body;
• being in a stressful state that promotes the release of adrenaline;
• connective tissue dysplasia;
• cervicothoracic osteochondrosis, creating ideal conditions for disruption of myocardial innervation;
• congenital and acquired heart defects;
• hypertrophic cardiomyopathy;
• placental insufficiency, hypoxia prenatal or during childbirth;
• neuroendocrine diseases;
• violations of the polarization of individual cardiomyocytes;
• elevated cholesterol levels;
• genetic predisposition.

Among the causes of pathology, there are hereditary and various diseases acquired as a result of lifestyle. Diseases that provoke early polarization are cardiac and non-cardiac in nature. Signs may not be felt in any way in the physical plane and appear only according to the results of electrocardiography.

• headaches, dizziness during physical and mental stress;
• memory impairment, decreased concentration;
• difficulty breathing, shortness of breath;
• prolonged heart palpitations that are not relieved by medications.

There may be systematic jumps in blood pressure, discomfort in the region of the heart caused by dystrophic changes in the heart muscle, which reduce the filling of the coronary vessels.

The danger of early repolarization

Violation of the transmission of an electrical impulse along the conducting paths leads to a violation of the repolarization processes in the direction of acceleration, without giving the heart the opportunity for normal rest.

1. Fainting is a sudden loss of muscle tone and consciousness as a result of a deterioration in cerebral blood supply. In pathology, the most common cause is a violation of the rhythm of ventricular contractions, characterized by spontaneity of onset and recovery.
2. Ventricular fibrillation is a dangerous violation of contractions, accompanied by rapid, unregulated and uncoordinated movements of cardiomyocytes. Without the provision of medical assistance in an urgent manner, cardiac arrest occurs, because within a few seconds from the moment the attack begins, the patient loses consciousness, followed by a loss of pulse and respiratory arrest.
3. Myocardial infarction - necrosis of sections of the heart muscle, provoked against the background of coronary artery disease, as a result of uncontrolled atrial fibrillation. If a large area of ​​the myocardium is damaged and timely medical care is not provided, it can lead to death.

Differential Diagnosis

The pathological process is fixed on the basis of electrocardiography.

The following deviations are possible on the cardiogram:

1. Roughness of the ST segment (with the exception of the S wave), showing the time interval between depolarization and repolarization. In the absence of deviations, it should be on the isoline. Early repolarization can be graphically expressed in its rise up or the presence of a downward bulge.
2. An increase in the height of the R wave - the beginning of the relaxation phase in the chest leads. At the same time, there is a change or complete disappearance of the S wave.
3. Point S is on or above the isoline. Normally, the S wave should be below the isoline.
4. Irregularity of the descending segment of the R wave, which is ideally even.
5. An increase in the duration of ventricular depolarization, which manifests itself in the expansion of the QRS complex graphically.

In addition to an electrocardiogram, to confirm the diagnosis and severity of the pathological process, a stress ECG and daily monitoring are performed. For complex diagnostics, a lipid profile and a biochemical blood test are performed.

Treatment and prevention

In the absence of symptoms, concomitant cardiac pathologies, coronary syndromes and arrhythmias, the patient is prescribed only preventive methods that involve reducing physical activity, giving up bad habits, normalizing sleep, avoiding stress, and adjusting the diet.

The diet should include foods rich in potassium and B vitamins. Useful components are present in fresh vegetables and fruits, nuts, seafood and sea fish.

1. Medication
   therapy. Patients are recommended energy-tropic drugs that improve heart trophism and facilitate work. In cardiac pathologies, the use of specific drugs aimed at combating diseases is of great importance. Antihypertensive and antihypertensive drugs are prescribed to stabilize blood pressure. To improve the blood supply to the heart muscle - coronary lytics, acting by expanding the coronary arteries. With arrhythmia, drugs are prescribed that help slow down repolarization, due to which the rhythm of the heart fails.
2. Operational intervention. If the heart rhythm failures are dangerous, the patient is implanted with a cardioverter-defibrillator. It is placed under the skin on the chest. From the device, electrodes are inserted into the cavity of the heart, through which, during attacks of arrhythmia, an electrical discharge is applied, which helps to restore the heart rhythm. The operation is recommended for people who have experienced fainting and ventricular fibrillation, as well as people whose relatives died at a young age from sudden cardiac arrest.

Features of the treatment of children and adolescents

The reasons for the development of early repolarization of the ventricles in children may be congenital heart defects, placental insufficiency and hypoxia during fetal development, genetic predisposition and nervous disorders.

The choice of treatment regimen is determined by the doctor depending on the causes, severity, course of the disease and possible consequences. In the case of an asymptomatic course with the preservation of sinus rhythm, only preventive measures are prescribed. In order to prevent the progress of the disease, the child must be constantly monitored by a cardiologist, which will ensure the study of the dynamics.

• lifestyle modifications and adherence to dietary recommendations;
• protection from stressful situations;
• prevention of bad habits in the form of smoking, drug and alcohol use in adolescence;
• protection from physical loads, especially during puberty;
• with a positive reaction of tests for potassium, include mineral complexes with a high content of the element in the diet;
• taking drugs that stabilize the work of the heart muscle, normalize metabolic processes and strengthen the body as a whole.

With severe violations of cardiac activity, the occurrence of complications, the doctor may decide to use radical methods, which include radiofrequency ablation - a low-traumatic intervention using special catheters inserted into the region of the heart through the vessels in order to eliminate arrhythmia.

Features of the treatment of athletes

Due to the high physical exertion associated with professional activities, 80% of athletes have a slow heart rhythm - bradycardia. Early polarization of the ventricles often results from the development of specific wall thickening in the left ventricle, an increase in the volume of the cardiac chambers, and an increase in vagal tone.

• reduce physical activity;
• do not use doping;
• see a cardiologist on a regular basis.

The syndrome of early repolarization in the vast majority does not pose a danger to health and life, but is subject to medical supervision in order to study the dynamics, prevent the development of pathological processes, progress and development of complications. Therefore, the task of the patient is to undergo regular examinations, the task of doctors is to identify the possibility of irreversible consequences and prevent their occurrence before a catastrophe occurs.