The S-T Segment, T-wave and U-wave

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The S-T segment represents the time delay between systole and the repolarization of the ventricle. The S-T segment is normally isoelectric and falls on the baseline. Should the S-T segment be elevated above the baseline this would indicate a myocardial injury, usually an infarction.

The T-wave is normally a positive deflection and represents the repolarization of the ventricles (i.e. the Na+ and Ca++ ions are pumped out of the muscle cells). During this time, the cells become progressively less refractory. Should ischemia be present, the necessary energy provided via the blood stream nutrients may be delayed and the T-wave may be flattened or inverted.

The U-wave, if it can be seen on the ECG, is seen after the T-wave. A significant U-wave, defined as being 0.04 seconds wide (one small square) or having its spike depth 1/3 the height or depth of the QRS complex, is highly suggestive of myocardial infarction.


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