The ECG changes due to altitude and to catecholamines

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Abstract
Summary In order to distinguish the effects of beta-receptor stimulation on the ECG from other factors during short-term adjustment to hypoxic aerohypoxia, the ECG of 19 volunteers were compared during moderately acute, stepwise exposure to high altitude (6,000 m) in a low pressure chamber, once with and once without beta-receptor blockade (propranolol), and after isoprenaline inhalation at ground level. The results show that beta-receptor stimulation accounts mainly for most ECG changes during altitude exposure, i.e., for the shortening of R-R interval, the lengthening of Q-T and in particular for the ST-T flattening, the latter therefore being only an indirect sign of hypoxia. After exclusion of the catecholamines, the minor but still significant ECG changes at altitude (shortening of R-R interval, increase of P wave, prolongation of P-Q, deviation of the R vector, T wave flattening in the left precordial leads) may be attributed to other, so far undefined factors, such as cardiac hypoxia, vagal withdrawal, or increase of pulmonary resistance.