ST上昇、ST部分上昇

WordNet

angular distance above the horizon (especially of a celestial object) (同)EL, altitude, ALT
(ballet) the height of a dancers leap or jump; "a dancer of exceptional elevation"
distance of something above a reference point (such as sea level); "there was snow at the higher elevations"
drawing of an exterior of a structure
the event of something being raised upward; "an elevation of the temperature in the afternoon"; "a raising of the land resulting from volcanic activity" (同)lift, raising
divide or split up; "The cells segmented"
one of the parts into which something naturally divides; "a segment of an orange"
divide into segments; "segment an orange"; "segment a compound word" (同)section
the 19th letter of the Roman alphabet (同)s

PrepTutorEJDIC

〈U〉〈C〉《文》(…を…に)『高めること』,昇進(向上)させること《+『of』+『名』+『to』+『名』》 / 〈U〉《文》気高さ,高尚 / 〈C〉《文》隆起したところ;高地 / 《単数形で》(地表・海面からの)『高さ』;地上,海抜 / 〈C〉(建物などの)立面図,正面図 / 《単数形で》仰角
区分,部分 / 切片(円などの一部);(直線の)線分 / …‘を'分ける / 分かれている,分裂する
sulfurの化学記号 / {略}South[ern]

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/09/09 06:13:10」(JST)

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Schematic representation of normal ECG, with ST segment in purple. J point is the point where red and purple segments overlap

12-lead electrocardiogram showing ST-segment elevation (orange) in I, aVL and V1-V5 with reciprocal changes (blue) in the inferior leads, indicative of an anterior wall myocardial infarction.

ST elevations refers to a finding on an electrocardiogram wherein the trace in the ST segment is abnormally high above the baseline.

Measurement

An ST elevation is considered significant if the vertical distance inside the ECG trace and the baseline at a point 0.24 seconds after the J-point is at least 0.9 mV (usually representing 1 mm or 1 small square) in a limb lead or 0.29 mV (2 mm or 2 small squares) in a precordial lead.^[1] The baseline is either the PR interval or the TP interval.^[2] This measure has a false positive rate of 15-20% (which is slightly higher in women than men) and a false negative rate of 20-30%.^[3]

Physiology

The ST segment corresponds to a period of ventricular depolarization. Because of the complete depolarization of the ventricles, in theory there is no net movement of charge during the ST segment. Repolarization of the ventricle normally occurs during the T wave, however one cause of ST segment elevation is the early repolarization of the heart wall due to transmural ischemia. During transmural (subepicardial ischemia) the injured cells are "relatively" closer to the epicardial surface. In the case of depolarization, healthier cells will typically displace a larger amplitude and duration of depolarization. During systole, a ventricle with subepicardial ischemia will exhibit cells with higher amplitude of depolarization in the cardiac endocardium. Under physiological conditions the ST segment is isoelectric (i.e. same charge across the myocardium), however in some circumstances (e.g. transmural infarct) there is partial depolarization of the cardiac myocytes that have undergone ischemia. A consequence of decreased O₂ perfusion will be decreased production of ATP, which is needed to operate the Na⁺/K⁺ATPase which is responsible for the final stages of myocyte repolarization (-80mV to -90mV), thus these cells will only be partially depolarized compared to surrounding healthy (non-ischemic) myocytes. The difference in membrane potential between healthy and ischemic cells causes negative charges to accumulate on their surfaces, generating a vector that points towards the normal cardiac cells (which have positive charges on their surface). This vector points away from the chest EKG leads, causing a downward deflection in the TP segment. However, since the TP segment is the baseline of the EKG, the machine corrects for this by raising TP to baseline which results in ST elevation. Also see ST depression.

Associated conditions

The exact topology and distribution of the affected areas depend on the underlying condition. Thus, ST elevation may be present on all or some leads of ECG.

It can be associated with:

Myocardial infarction (see also ECG in myocardial infarction). ST elevation in select leads is more common with MI. ST elevation only occurs in full thickness infarction
Prinzmetal's angina^[4]
Acute pericarditis^[5]^[6] ST elevation in all leads is more common with acute pericarditis.
Left ventricular aneurysm^[7]
Blunt trauma to the chest resulting in a cardiac contusion^[8]
Hyperkalemia^[4]
Acute myocarditis^[4]
Pulmonary embolism^[4]
Brugada syndrome^[4]
Hypothermia^[4]
J-point elevation^[4]
Early repolarization

References

^ Family Practice Notebook > ST Elevation Retrieved Nov 2010
^ Khandpur, R.S. (2003). Handbook of biomedical instrumentation (2nd ed.). New Delhi: Tata McGraw-Hill. p. 255. ISBN 978-0-07-047355-3.
^ Sabatine MS (2000). Pocket Medicine (이소연). Lippincott Williams & Wilkins. ISBN 0-7817-1649-7. ^{[page needed]}
^ ^a ^b ^c ^d ^e ^f ^g Thaler, Malcolm (2009). The only EKG book you'll ever need. Lippincott Williams & Wilkins. ISBN 978-1-60547-140-2. ^{[page needed]}
^ Tingle LE, Molina D, Calvert CW (November 2007). "Acute pericarditis". American Family Physician. 76 (10): 1509–14. PMID 18052017.
^ Chew HC, Lim SH (November 2005). "Electrocardiographical case. ST elevation: is this an infarct? Pericarditis" (PDF). Singapore Medical Journal. 46 (11): 656–60. PMID 16228101.
^ Victor F. Froelicher; Jonathan Myers (2006). Exercise and the heart. Elsevier Health Sciences. pp. 138–. ISBN 978-1-4160-0311-3. Retrieved 10 October 2010.
^ Plautz CU, Perron AD, Brady WJ (July 2005). "Electrocardiographic ST-segment elevation in the trauma patient: acute myocardial infarction vs myocardial contusion". The American Journal of Emergency Medicine. 23 (4): 510–6. doi:10.1016/j.ajem.2004.03.014. PMID 16032622.

UpToDate Contents

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1. 心電図チュートリアル：SＴ波およびT波の変化 ecg tutorial st and t wave changes
2. ST上昇型心筋梗塞の急性期マネージメントの概要 overview of the acute management of st elevation myocardial infarction
3. ST上昇型心筋梗塞における血栓溶解療法：効果の指標 fibrinolytic thrombolytic agents in acute st elevation myocardial infarction markers of efficacy
4. 不安定狭心症および非ST上昇型心筋梗塞の急性期マネージメントの概要 overview of the acute management of unstable angina and non st elevation myocardial infarction
5. ST上昇型心筋梗塞の非急性期マネージメントの概要 overview of the non acute management of st elevation myocardial infarction

English Journal

The value of the Clinical SYNTAX Score in predicting long-term prognosis in patients with ST-segment elevation myocardial infarction who have undergone primary percutaneous coronary intervention.

Cetinkal G1, Dogan SM, Kocas C, Abaci O, Arslan S, Balaban Kocas B, Karaca OS, Buyuk A, Firidin N, Yildiz A.
Coronary artery disease.Coron Artery Dis.2016 Mar;27(2):135-142.
BACKGROUND: The Clinical SYNTAX Score (CSS) combines anatomical and clinical risk assessment.OBJECTIVES: This study was designed to evaluate CSS as a predictor of prognosis in patients with ST-elevation myocardial infarction (STEMI) undergoing a primary percutaneous coronary intervention (p-PCI).MET
PMID 26720108

Association of admission serum laboratory parameters with new-onset atrial fibrillation after a primary percutaneous coronary intervention.

Karataş MB1, Çanga Y, İpek G, Özcan KS, Güngör B, Durmuş G, Onuk T, Öz A, Şimşek B, Bolca O.
Coronary artery disease.Coron Artery Dis.2016 Mar;27(2):128-134.
OBJECTIVES: New-onset atrial fibrillation (NOAF) during hospitalization is considered a frequent complication associated with worse outcomes in the setting of ST-segment elevation myocardial infarction (STEMI). We aimed to investigate the association of admission serum laboratory parameters, neutrop
PMID 26693808

Prognostic importance of mitral regurgitation complicated by acute myocardial infarction during a 5-year follow-up period in the drug-eluting stent era.

Kim TH1, Lee KY, Choi Y, Park HW, Lee YS, Koh YS, Park HJ, Kim PJ, Chang K, Chung WS, Kim DB, Her SH, Park CS, Lee JM, Kim HY, Yoo KD, Jeon DS, Ahn Y, Jeong MH, Seung KB.
Coronary artery disease.Coron Artery Dis.2016 Mar;27(2):109-115.
BACKGROUND: Mitral regurgitation (MR) is a frequent complication of left-ventricular dysfunction, with an incidence ranging from 13 to 59% after acute myocardial infarction (AMI), which is associated with poor clinical outcome. The aim of this study was to assess the clinical and angiographic charac
PMID 26626143

Japanese Journal

Impact of Metabolic Syndrome on Various Aspects of Microcirculation and Major Adverse Cardiac Events in Patients With ST-Segment Elevation Myocardial Infarction

UCHIDA Yasuhiro,ICHIMIYA Satoshi,ISHII Hideki,KANASHIRO Masaaki,WATANABE Junji,YOSHIKAWA Daiji,TAKESHITA Kyosuke,SAKAI Shinichi,AMANO Tetsuya,MATSUBARA Tatsuaki,MUROHARA Toyoaki
Circulation journal : official journal of the Japanese Circulation Society 76(8), 1972-1979, 2012-07-25
… Methods and Results: In 216 consecutive patients with ST-segment elevation myocardial infarction (STEMI) after successful primary PCI, data were collected and analyzed on epicardial coronary flow, ST-segment resolution (STR) on electrocardiography, maximum serum creatine kinase levels, and the incidence of major adverse cardiac events (MACE). …
NAID 10030504885

Genetic, Molecular and Cellular Mechanisms Underlying the J Wave Syndromes

ANTZELEVITCH Charles
Circulation journal : official journal of the Japanese Circulation Society 76(5), 1054-1065, 2012-04-25
… An early repolarization (ER) pattern in the ECG, distinguished by J-point elevation, slurring of the terminal part of the QRS and ST-segment elevation has long been recognized and considered to be a benign electrocardiographic manifestation. …
NAID 10030131896