HEART DISEASE EXPERT FORUM
ST Segment Elevation

ST Segment Elevation

I was in the hospital in July 06 for what I thought was severe gas and it ended up being a 70% blockage in the left anterior descending artery.  I am on Plavix, Asprin, Tricor, lipitor, Toporal XL, Lipitor.  I seem to be ok except for I stumble a lot when I walk could it be due to any of these medications that I am taking.

My main question is when I was in the hospital my medical report said that i showedST segment Elevation with out any sympthoms, what is ST segment elevation and what did that represent at the time it was noted.  Any time that I have catherizations or colonoscophy test does my heart hart always drops to the 40's and they have to wait to stabelizebe why is this?
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The Toprol XL if it lowers your heart rate and blood pressure too much could potentially make you feel unsteady on your feet.

ST segment elevation is an electrocardiographic marker.  We typically use it to identify very high risk patients who present with caridac chest pain.  The ST elevation represents a current of injury in the myocardium that spans the whole thickness of the heart wall.  That means that a large area of myocardium is at risk and those patients are typically rushed to the cath lab.  ST elevation on an EKG is not 100% specific to injury.  It may also be a normal variant, especially when there is no chest pressure, it may represent an aneurysm or buldging of an already dead part of the heart wall from a previous heart attack, and then there are other conditions that are sometimes associated with it as well.  Therefore, depending on what your current heart function is, finding of ST elevation on an EKG without chest pain may mean that it is a normal variant, or that you really did have a heart attack in the past prior to that hospitalization.  You should probably have an echocardiogram to evaluate your heart function if you haven't already had that done.    

The drop is your heart rate to the 40's may mean many things.  Depending on your age it may be related to conduction disease in your heart that gets exacerbated by sedative medications.  It may be that you fall asleep with the sedative meds and a low heart rate with normal blood pressure is nothing to worry about.  Most of us have heart rates in the 40's when we fall asleep.  The Toprol XL may keep your heart rate low (the reason why you are onsteady on your feet sometimes) and adding on the sedative meds makes that worse leading to lower heart rate and lower blood pressure.  If the latter is true than you should probably adjust the dose of the Toprol.  
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