On my recent EKG, the main concern was STT changes. What does that mean? He also said that sinus arrhythmia might be a factor considering the previous EKG’s. How important are these things? Would taking a Cardiolite exam really change my treatment very much?

On my recent EKG, the main concern was STT changes. What does that mean? He also said that sinus arrhythmia might be a factor considering the previous EKG’s. How important are these things? Would taking a Cardiolite exam really change my treatment very much?
Hi there Fkissam. The ST segment is the area on the EKG that is between the end of the QRS complex and the start of the T-wave which follows the QRS complex. There are a couple of changes that can occur with the ST segment, and they are ST segment depression and ST segment elevation. ST segment depression that is significant (i.e. more than 1mm) usually means that there is an area of ischemia (low blood flow) in the heart. You can guess that low blood flow can be an indication of an impending infarction (i.e. heart attack). ST segment elevation, if significant, usually means that there has been an acute infarction of heart muscle.

Now, that being said, there are two caveats. If you have ST segment changes, and are having symptoms like chest pain, and shortness of breath and exercise intolerance, then and ONLY then are they concerning. Otherwise, it's just a pretty picture on a piece of paper. You HAVE to correlate clinical factors with what you find on the EKG.

In terms of ST segment elevation, it also has to be in leads that are next to each other....i.e. (I and AVL) or (II, II and AVF) AND the patient is having symptoms (chest pain, SOB..) for it to be suspicious of a heart attack. If there is ST elevation in every lead and the patient has chest pain, it's more indicative of pericarditis.

I am assuming a cardiolite examination is like a stress test on the heart (I think we call it something different in Canada). Yes, it would change the treatment. Why? Well, if you have changes on your EKG, the cardiologist has to find out whether these changes actually represent true ischemia, or just artefact. The cardiologist will stress your heart a bit....if the ST segment changes appear AND you start having symptoms like chest pain, then it would probably be a good idea for you to be put on cardioactive drugs. Otherwise, there is no need for them.

I know that's a lot of information to take in all at once, but if you want to, you can ask me specific questions.

ButterflyTrans ... you REALLY know your stuff. So I am going to give you the entire lowdown and test your skill! Here it is :


I am in my mid-40s and quite athletic.

I need help pretty quickly if somebody is willing. Due to insurance coverage reasons, I am scheduled to take a Persantine Cardiolite within a few days. I am NOT sure that I need this.

I had received 2 EKG reports that were slightly abnormal on Pre-Op for major neck surgery that I had in May. However the doctor said my heart was adequate for major neck surgery. I underwent the surgery and have recovered very well.

The 1st EKG result before neck surgery was:
()Heart rate varies from 69 to 100. ???Arrhythmia
()Accelerated AV conduction
()Left axis deviation , consider LAFB
()Borderline low voltage in front leads

The 2nd EKG result was taken a few days later … but still BEFORE neck surgery:
()Sinus Rhythm
()Marked Left Axis Deviation
()Low QRS Voltages in Standard Limb Leads

In my life, all my previous EKG’s were normal. The disc that flattened my spine in my neck definitely did cause some heart irregularities. My surgeon said that happens in many patients.

Now it is 7 months after neck surgery. I had another EKG done. The cardiologist only sent a small portion of the EKG. On this recent EKG, the main concern was STT changes. What does that mean? He also said that sinus arrhythmia might be a factor considering the previous EKG’s. How important are these things? Would taking a Cardiolite exam really change my treatment very much?

I don’t quite understand these results. Are any of these results significant or something to worry about? My cardiologist today didn’t explain much. He said it could be as simple as problems with potassium or magnesium. My potassium levels were OK on the 2 pre-surgery EKG’s. My magnesium levels are always low at around 20 when the norm is 32-122.

My virtual heart scans came out negative. I had 0% calcification even tho my cholesterol has been between 200 and 290 for the last 20 years. (It is NOT my diet … it is everybody in my family). My HDL is normal. My LDL is hi … usu around 168 and the norm is 0 to 130.

The doctor ONLY spent 2 minutes with me. If I wanted further testing, he recommended echocardiogram AND a persantine cardiolite test. The cardiolite injection is a radioactive substance so they can see the heart. The persantine is used to increase bloodflow since I might not have recuperated from orthopedic surgery to use the treadmill. However, I think I may just use the treadmill rather than the chemical due to side effects of the chemical.

The overall assessment of my health is that many body functions were impaired by the pressure and flattening of the cervical disk on my spine. In general, I am feeling quite well. I am hoping that I can delay any intensive Cardiolite tests and just let the body recuperate on its own.

Any thoughts or precautions on my EKG results? Or any thoughts on the Cardiolite test?
If I upload the scanned EKG images, does anybody know how to interpret them?