Pseudoischemic "false positive" S-T segment changes induced by hyperventilation in patients with mitral valve
The American Journal of Cardiology
|May 1, 1980
Summary
Hyperventilation can cause S-T segment changes mimicking heart issues. This study found these changes strongly predict mitral valve prolapse, especially in women, suggesting a link to autonomic factors.
Area of Science:
- Cardiology
- Electrocardiography
- Cardiovascular Physiology
Background:
- Hyperventilation can induce S-T segment changes resembling myocardial ischemia.
- The underlying cause of these electrocardiographic changes remains undefined.
Purpose of the Study:
- To investigate the origin of S-T segment changes observed during hyperventilation.
- To determine the diagnostic significance of hyperventilation-induced S-T segment changes.
Main Methods:
- Reviewed records of 1,678 patients undergoing hyperventilation and treadmill exercise testing.
- Identified patients with ischemic-appearing S-T segment changes post-hyperventilation.
- Assessed for mitral valve prolapse and coronary artery disease in identified patients.
Main Results:
- 1.7% of patients (28/1678) showed S-T segment changes after hyperventilation.
- Of 21 patients with follow-up, 76% (16/21) had evidence of mitral valve prolapse.
- Mitral valve prolapse was particularly prevalent in women (88% of female patients).
- Exercise tests were often negative, and coronary angiography revealed minimal disease.
Conclusions:
- Hyperventilation-induced S-T segment changes are highly predictive of mitral valve prolapse.
- This association is particularly strong in women.
- Autonomic factors may play a role in the pathogenesis of abnormal hyperventilation responses in mitral valve prolapse.
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