Differential diagnosis of repolarization disorders in coronary heart disease and benign conditions on a resting electrocardiogram

Currently, with the abundance of scientific information, specialists face questions in interpreting repolarization disturbances for formulating an electrocardiographic diagnosis. The formulations accepted in domestic electrocardiography methodology, such as “focal changes in the myocardium” for coronary blood flow disorders, and “diffuse changes in the myocardium” for nonspecific repolarization disturbances, are not always related to coronary pathology. Furthermore, there is confusion in interpreting ECG signs of ischemia and/or myocardial damage in coronary pathology. The article reviews modern electrocardiographic criteria for diagnosing primary specific, nonspecific, and secondary repolarization disturbances in the myocardium that are most frequently encountered in clinical practice. The relevance of differential diagnosis of the causes of ST segment depression and elevation, T wave inversion on the ECG is due to the high frequency of pathological conditions underlying them, the difficulty of diagnosis, and significant differences in therapeutic tactics and disease prognosis. Modern concepts of the complex electrophysiological processes occurring in the heart under normal conditions, in myocardial hypertrophy, and at various stages of ischemic heart disease are outlined. The aim of this work is to present current scientific data in the field of interpreting repolarization disturbances on resting ECGs in ischemic heart disease and benign conditions.