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STEMI ECG

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https://www.readbyqxmd.com/read/28936441/correlation-between-electrocardiographic-changes-and-coronary-findings-in-patients-with-acute-myocardial-infarction-and-single-vessel-disease
#1
Abdallah Sanaani, Srikanth Yandrapalli, George Jolly, Rajiv Paudel, Howard A Cooper, Wilbert S Aronow
BACKGROUND: Correlation of ST-segment elevation on the 12-lead electrocardiogram (ECG) with the expected affected coronary territory is established in patients with ST-elevation myocardial infarction (STEMI). In patients with non-ST-elevation myocardial infarction (NSTEMI), correlation of ischemic ECG abnormalities with the affected coronary territory has not been well-established. We sought to investigate the correlation of electrocardiographic abnormalities with the location of 1-vessel obstructive coronary artery disease (CAD) in patients with both STEMI and NSTEMI...
September 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28928045/the-electrocardiographic-triangular-qrs-st-t-waveform-pattern-in-patients-with-st-segment-elevation-myocardial-infarction-incidence-pathophysiology-and-clinical-implications
#2
Alberto Cipriani, Gianpiero D'Amico, Giulia Brunello, Martina Perazzolo Marra, Federico Migliore, Luisa Cacciavillani, Giuseppe Tarantini, Barbara Bauce, Sabino Iliceto, Domenico Corrado, Alessandro Zorzi
BACKGROUND: A specific ECG pattern of presentation of ST-segment elevation acute myocardial infarction (STEMI), characterized by "triangular QRS-ST-T waveform" (TW), has been associated with poor in-hospital prognosis but longitudinal data on its incidence and clinical impact are lacking. We prospectively evaluated the incidence and prognostic meaning of the TW pattern in a cohort of consecutive STEMI patients. METHODS: All STEMI patients who presented within 12h of symptoms onset and showed no complete bundle branch block or paced ventricular rhythm were included...
August 16, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28918213/myocardium-at-risk-assessed-by-electrocardiographic-scores-and-cardiovascular-magnetic-resonance-a-mitocare-substudy
#3
Maria Sejersten, Yama Fakhri, Marianne Pape, Svend Eggert Jensen, Einar Heiberg, Henrik Engblom, Trygve S Hall, Dan Atar, Peter Clemmensen
INTRODUCTION: The myocardium at risk (MaR) represents the quantitative ischemic area destined to myocardial infarction (MI) if no reperfusion therapy is initiated. Different ECG scores for MaR have been developed, but there is no consensus as to which should be preferred. OBJECTIVE: Comparisons of ECG scores and Cardiac Magnetic Resonance (CMR) for determining MaR. METHODS: MaR was determined by 3 different ECG scores, and by CMR in ST-segment elevation MI (STEMI) patients from the MITOCARE cardioprotection trial...
August 16, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28892952/correlation-of-reciprocal-changes-and-qrs-amplitude-in-ecg-to-left-ventricular-dysfunction-wall-motion-score-and-clinical-outcome-in-first-time-st-elevation-myocardial-infarction
#4
Silpita Katragadda, Murali Alagesan, Shanmugasundaram Rathakrishnan, Deepalakshmi Kaliyaperumal, Anith Kumar Mambatta
INTRODUCTION: Electrocardiogram (ECG) is the simplest tool for diagnosing ST Elevation Myocardial Infarction (STEMI). We can use a12 lead ECG for prognostication purposes also. AIM: The aim of the study was to find out the role of ECG as a prognostic marker in terms of clinical outcome and wall motion abnormality. MATERIALS AND METHODS: It was a prospective study done in PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India, from January 2014 to September 2014...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28890792/multicentre-analysis-of-current-st-elevation-myocardial-infarction-acute-care-pathways
#5
Joppe Tra, Carolien de Blok, Ineke van der Wulp, Martine C de Bruijne, Cordula Wagner
BACKGROUND: Rapid reperfusion with percutaneous coronary intervention (PCI) is vital for patients with ST segment elevation myocardial infarction (STEMI). However, the guideline-recommended time targets are regularly exceeded. The goal of this study was to gain insight into how Dutch PCI centres try to achieve these time targets by comparing their care processes with one another and with the European guideline-recommended process. In addition, accelerating factors perceived by care providers were identified...
2017: Open Heart
https://www.readbyqxmd.com/read/28885062/out-of-hospital-cardiac-arrest-always-coronary-angiography
#6
Andrea Rognoni, Chiara Cavallino, Marco Giovanni Mennuni, Lucia Barbieri, Roberta Rosso, Francesco Rametta, Federico Nardi, Alessandro Lupi, Angelo Sante Bongo
Out-of-hospital cardiac arrest (OHCA) remains one of the principle challenges in the setting of critical care medicine and emergency cardiology. Areas covered: Long-term survival rates even after successful resuscitation are variable but increasing in the recent years; due to the improvement of base and advanced cardiac life support techniques an increasing number of resuscitated patients are admitted to the hospital. Recent data suggested that patients surviving to hospital discharge after OHCA presented long-term outcome similar to patients with ST-elevation myocardial infarction...
September 18, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28868102/a-novel-electrocardiographic-sign-of-an-st-segment-elevation-myocardial-infarction-equivalent-de-winter-syndrome
#7
Mustafa Ugur Goktas, Ozgur Sogut, Mehmet Yigit, Onur Kaplan
Patients with de Winter syndrome, also termed anterior ST-segment elevation myocardial infarction (STEMI)-equivalent, represent 2% of all patients with acute anterior myocardial infarctions admitted to emergency departments (EDs). STEMI-equivalents do not present with classical electrocardiogram (ECG) changes but exhibit a critical stenosis of the left anterior descending (LAD) coronary artery. This is under-recognized by clinicians and is therefore associated with high morbidity and mortality. Here, we report a rare case of a novel, typical, STEMI-equivalent ECG pattern without obvious ST-segment elevation in a 34-year-old female who presented to our ED with substantial chest pain and a large, acute, transmural anterior myocardial infarction caused by acute occlusion of the LAD coronary artery...
August 2017: Cardiology Research
https://www.readbyqxmd.com/read/28867265/implantable-cardioverter-defibrillator-implantation-rates-after-out-of-hospital-cardiac-arrest-are-the-rates-guideline-concordant
#8
Edwin C Ho, Sheldon Cheskes, Paul Angaran, Laurie J Morrison, Theresa Aves, Cathy Zhan, Dennis T Ko, Paul Dorian
BACKGROUND: Clinical practice guidelines recommend implantable cardioverter defibrillators (ICDs) for the secondary prevention of sudden death after a cardiac arrest not from a reversible cause, but "real world" implantation rates are not well described. METHODS: Adults with out of hospital cardiac arrest attended by Emergency Medical Services are captured in the Toronto Regional RescuNET database. We analyzed those who survived to hospital discharge and collected data on age, sex, initial rhythm, ST-elevation myocardial infarction (STEMI) on presenting electrocardiogram (ECG), in-hospital revascularization, neurologic status (Modified Rankin Scale [MRS]) at discharge, and admission hospital type...
August 23, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28774770/the-misleading-electrocardiogram-midventricular-takotsubo-masquerading-as-anterior-wall-stemi
#9
Sonal Pruthi, Semaan Kobrossi, Rajeev Bartaula, Debanik Chaudhuri
Midventricular Takotsubo cardiomyopathy (TC) is a relatively rare variant of stress induced cardiomyopathy, wherein there is akinesis of only the mid-ventricular segment with or without hyperkinesis of apical and basal ventricular segments. The ECG findings of TC typically do not include ST segment elevation in V1-V2 and are unlikely to be associated with reciprocal changes in inferior leads. The presence of these changes argues strongly in favor of anterior wall STEMI. In our patient, the ECG had changes strongly suggestive of STEMI, however had normal coronaries on cardiac catheterization...
July 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28751014/disappearance-of-pathologic-anteroseptal-q-waves-after-reperfusion-with-percutaneous-coronary-intervention-pci-in-a-61-year-old-female-a-case-report
#10
Omar Abdel-Razek, Brendan P Parfrey, Sean P Connors
We report a case of a 61 year old female with disappearance of anteroseptal Q waves following an anterior STEMI. At presentation a 12 lead ECG revealed frank anteroseptal Q waves and T wave inversion (V1-V3). The patient underwent percutaneous coronary intervention (PCI) with drug eluting stenting to a critically stenosed left anterior descending artery. At a five month follow-up visit a 12 lead ECG demonstrated the complete resolution of anteroseptal Q waves and normal R wave progression was seen in the precordial leads...
June 8, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28746519/single-derivation-fragmented-qrs-can-predict-poor-prognosis-in-successfully-revascularized-acute-stemi-patients
#11
Zulkif Tanriverdi, Huseyin Dursun, Tugce Colluoglu, Dayimi Kaya
Background: QRS fragmentation (fQRS) is classically defined as the presence of slurred QRS morphology in at least two contiguous leads, and its prognostic importance has been shown in ST elevation myocardial infarction (STEMI). However, no study has investigated the significance of single lead fQRS (sl-fQRS) in surface electrocardiography (ECG). Objectives: To evaluate whether sl-fQRS is as valuable as classical fQRS in patients with acute STEMI who had successful revascularization with primary percutaneous coronary intervention (pPCI)...
July 20, 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28728608/influence-of-apelin-12-on-troponin-levels-and-the-rate-of-mace-in-stemi-patients
#12
Xhevdet Krasniqi, Blerim Berisha, Masar Gashi, Dardan Koçinaj, Fisnik Jashari, Josip Vincelj
BACKGROUND: During acute myocardial infarction, phosphorylated TnI levels, Ca(2+) sensitivity and ATPase activity are decreased in the myocardium, and the subsequent elevation in Ca(2+) levels activates protease I (caplain I), leading to the proteolytic degradation of troponins. Concurrently, the levels of apelin and APJ expression are increased by limiting myocardial injury. METHODS: In this prospective observational study, 100 consecutive patients with ST-elevation acute myocardial infarction were included...
July 20, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28696573/prognostic-implications-of-q-waves-at-presentation-in-patients-with-st-segment-elevation-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention-an-analysis-of-the-horizons-ami-study
#13
Ioanna Kosmidou, Björn Redfors, Aaron Crowley, Bernard Gersh, Shmuel Chen, José M Dizon, Monica Embacher, Roxana Mehran, Ori Ben-Yehuda, Gary S Mintz, Gregg W Stone
BACKGROUND: Presence of Q waves on the presenting electrocardiogram (ECG) in patients with ST-segment elevation myocardial infarction (STEMI) has been associated with worse prognosis; however, whether the prognostic value of Q waves is influenced by baseline characteristics and/or rapidity of revascularization based on the guideline-based metric of door-to-balloon time remains unknown. HYPOTHESIS: We hypothesized that Q waves in the presenting ECG will be predictive of long term mortality regardless of time to reperfusion...
July 11, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28690292/atrial-fibrillation-on-admission-is-related-with-higher-mortality-in-st-segment-elevation-myocardial-infarction-patients
#14
MULTICENTER STUDY
Kyung-Kuk Hwang, Sang-Yong Eom, Sang Yeub Lee, Sang Min Kim, Myeong-Chan Cho, Young Jo Kim, Ki Bae Seung, Myung Ho Jeong, Jang-Whan Bae
The prognostic significance of atrial fibrillation (AF) on mortality in ST-segment elevation myocardial infarction (STEMI) patients is not clearly understood. To elucidate the clinical significance of AF on mortality for 1 year in STEMI patients, we retrospectively analyzed the Korea Acute Myocardial Infarction Registry (KAMIR) database, which spans January 2008 to September 2010 and includes 14,329 patients with acute myocardial infarction. We selected 5,556 patients with marked ECG rhythm (NSR, normal sinus rhythm or AF) on emergency room arrival, < 12 hours of symptom onset, and who underwent primary percutaneous coronary intervention (PCI) within 90 minutes of arriving at the hospital...
August 3, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28684393/critical-aortic-stenosis-presenting-as-stemi
#15
Ying X Gue, Sanjay S Bhandari, Damian J Kelly
A 73-year-old male was brought into hospital with chest pain and inferior ST elevation on ECG. The patient immediately proceeded to the catheter lab for primary percutaneous coronary intervention. Angiography did not identify any culprit lesions to account for the patient's electrocardiographic changes and ongoing symptoms of chest pain. Bedside echocardiography revealed critical aortic stenosis. Intra-aortic balloon pump (IABP) was inserted, resulting in resolution of chest pain and ST-segment changes. The patient underwent successful aortic valve (AV) replacement without the need for coronary intervention...
September 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28666458/risk-score-to-predict-false-positive-st-segment-elevation-myocardial-infarction-in-the-emergency-department-a-retrospective-analysis
#16
MULTICENTER STUDY
Ji Hoon Kim, Yun Ho Roh, Yoo Seok Park, Joon Min Park, Bo Young Joung, In Cheol Park, Sung Phil Chung, Min Joung Kim
BACKGROUND: The best treatment approach for ST-segment elevation myocardial infarction (STEMI) is prompt primary percutaneous coronary intervention (PCI). However, some patients show ST elevation on electrocardiography (ECG), but do not have myocardial infarction. We sought to identify the frequency of and to develop a prediction model for false-positive STEMI. METHODS: This study was conducted in the emergency departments (EDs) of two hospitals using the same critical pathway (CP) protocol to treat STEMI patients with primary PCI...
June 30, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28644212/worsening-atrioventricular-conduction-after-hospital-discharge-in-patients-with-st-segment-elevation-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention-the-horizons-ami-trial
#17
Ioanna Kosmidou, Björn Redfors, Thomas McAndrew, Monica Embacher, Roxana Mehran, José M Dizon, Ori Ben-Yehuda, Gary S Mintz, Gregg W Stone
BACKGROUND: The chronic effects of ST-segment elevation myocardial infarction (STEMI) on the atrioventricular conduction (AVC) system have not been elucidated. This study aimed to evaluate the incidence, predictors, and outcomes of worsened AVC post-STEMI in patients treated with a primary percutaneous coronary intervention (PCI). PATIENTS AND METHODS: The current analysis included patients from the HORIZONS-AMI trial who underwent primary PCI and had available ECGs...
June 21, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28636165/a-feasibility-and-safety-study-of-intracoronary-hemodilution-during-primary-coronary-angioplasty-in-order-to-reduce-reperfusion-injury-in-myocardial-infarction
#18
Michael McGarvey, Omar Ali, M Bilal Iqbal, Charles Ilsley, Joyce Wong, Carlo Di Mario, Simon Redwood, Tiffany Patterson, Dudley J Pennell, Paula Rogers, Miles Dalby
OBJECTIVES: We designed a pilot study to evaluate safety and feasibility of an inexpensive and simple approach to intracoronary hemodilution during primary angioplasty (PPCI) to reduce reperfusion injury. INTRODUCTION: Early revascularization in acute myocardial infarction decreases infarct size and improves outcomes. However, abrupt restoration of coronary flow results in myocardial reperfusion injury and increased final infarct size. Dilution of coronary blood during revascularization may help reduce this damage...
June 21, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28598044/a-study-of-prehospital-delay-patterns-in-acute-myocardial-infarction-in-an-urban-tertiary-care-institute-in-mumbai
#19
Ashar Khan, Milind Phadke, Yash Y Lokhandwala, Pratap J Nathani
OBJECTIVE: There is now increasing awareness about the need for early diagnosis in patients presenting with chest pain. Pre-hospital delay remains a major hurdle in the institution of early reperfusion therapy, which is crucial in salvaging 'at-risk' myocardium and reducing adverse cardiovascular events following ST elevation myocardial infarction (STEMI). This study aims to determine the incidence and the determinants of delayed presentation STEMI and the potential impact of such delay on adverse cardiovascular outcomes...
May 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28595746/ratio-of-high-sensitivity-troponin-to-creatine-kinase-mb-in-takotsubo-syndrome
#20
Charles Pirlet, Luc Pierard, Victor Legrand, Olivier Gach
BACKGROUND: Takotsubo syndrome (TT) and myocardial infarction (MI) share numerous similarities in clinical presentation, ECG modifications and biomarker elevation. We sought to determine whether the ratio of high-sensitivity cardiac troponin T (hs-TnT) to the myocardial fraction of creatine kinase (CKMB) could be a potent discriminator between TT and MI patients. METHODS: We separately present analysis of data from retrospective files and prospectively recruited patients presenting with TT (35 retrospective and 42 prospective), NSTEMI (48 retrospective and 75 prospective) and STEMI (20 retrospective and 39 prospective)...
September 15, 2017: International Journal of Cardiology
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