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What are nonspecific ST abnormalities on my EKG? Have high blood pressure and high heart rate.

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Cardiologist, Interventional
Practicing since : 1996
Answered : 192 Questions
I would like to know what nonspecific st abnormalities ,I have had 2 EKG both say same thing .I also have ras left ventricular hypertrophy ,myxomatous degeneration,moderate tricuspid regurgitation, my 24 hour urine shows high vma ,high norepinephrine,high calculated total ( e+ne) . I am a 44 year old female. , I have also just been diagnosed with high blood pressure. My heart rate is constantly high. I do not smoke ,nor drink anything but water , no medication except blood pressure ,and thyroid. I am 5/7 140 pounds I exercise everyday , weights and run 5 miles, my family history , well both parents are deceased.heart attack for my mother,in 2009 age 67 . quadruple bypass for my father at age 44. He recently passed away from untreated uti. In August 2011, I am looking for a second opinion , I will be going to another cardiologist on dec 5 and a nephrolgist on dec2, the nonspecific st abnormalities on my ekg is confusing . I can't get a straight answer what all this means together. Please help round this up. Also I would like to add I juice and do not eat red meat . Plus I feel incredible, I teach karate and believe they have be mistaken. I just need an answer thank you. Sincerely XXXXXXX
Posted Tue, 8 May 2012 in Hypertension and Heart Disease
Answered by Dr. Raja Sekhar Varma 9 hours later

Thank you for your query.

As I understand from the details that you have given, you are a 44 year old lady with a strong family history of coronary heart disease and on medication for high BP and thyroid problems. You have also been diagnosed as having urine VMA and catecholamines.

ST segment refers to a part of the ECG tracing after the QRS complex and before the T wave. In less technical terms, it is the early stage of electrical relaxation of the heart muscle. Specific ST segment changes like ST elevation or ST depression occur as specific responses to injury of the heart muscle or if the heart muscle does not get adequate blood supply. Non-specific ST segment changes refer to those changes in the ST segment which are not typical or specific to any particular cause. It is a non-diagnostic change which does not necessarily mean injury to the muscle and can occur as a general response to unrelated events.

“In your case, the changes in the ECG are likely to be due to the effect of high BP and high heart rate”.

The presence of high urine levels of VMA and norepinephrine/epinephrine is a pointer to a likely diagnosis of pheochromocytoma. This is an abnormal growth inside one or both of the adrenal glands located above the kidneys, leading to high levels of certain hormones leading to high BP and high heart rate. This needs to identified with a CT scan or MR imaging. Subsequently, surgery can be curative. Till then, you will need combined alpha and beta blocker drugs to control your BP and heart rate.

The presence of renal artery stenosis can also cause a high BP. This blockage in the blood supply to one or both of your kidneys will need to be treated depending on the severity of the blockage. While severe blockages can be treated with angioplasty/stenting or renal bypass surgery, mild blockages can be monitored and treated with medicines.

I hope this answer helps in resolving your doubts. If you need any further clarifications, feel free to get back to me again. Please accept my answer in case you do not have further queries.

With regards,
Dr RS Varma
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