Repolarisation alterations

Subepicardial ischaemia (primary repolarisation alteration) is frequently associated with LVE or LBBB (secondary repolarisation alteration), wherebymixed patterns are generated (Figure 3.27). 

Figure 4.51 Above Examples of four types of repolarisation alterations that can be seen in sportsmen without heart disease (Plas, 1976). Below Drawings of more typical changes in V2.

Heart diseases cardiomyopathy, valvular heart disease, pericarditis, hypertension, ECG alterations (left bundle branch block, WPW, repolarisation alterations, etc). 

The morphology of ST-segment depression is more difficult to assess in the presence of a wide QRS complex or LVE. In this situation mixed repolarisation changes can be observed (alterations secondary to LVH or LBBB and primary alterations due to ischaemia) (see ECG pattern of injury in patients with ventricular hypotrophy and/or wide QRS ) (p. 120). 

We will refer to the diagnosis in the chronic phase. The hemiblocks do not alter the repolarisation changes that can be observed in the acute phase of MI. 

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