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https://www.readbyqxmd.com/read/28060863/the-systematic-evaluation-of-identifying-the-infarct-related-artery-utilizing-cardiac-magnetic-resonance-in-patients-presenting-with-st-elevation-myocardial-infarction
#1
Carine E Hamo, Igor Klem, Sunil V Rao, Vincent Songco, Samer Najjar, Edward G Lakatta, Subha V Raman, Robert A Harrington, John F Heitner
BACKGROUND: Identification of the infarct-related artery (IRA) in patients with STEMI using coronary angiography (CA) is often based on the ECG and can be challenging in patients with severe multi-vessel disease. The current study aimed to determine how often percutaneous intervention (PCI) is performed in a coronary artery different from the artery supplying the territory of acute infarction on cardiac magnetic resonance imaging (CMR). METHODS: We evaluated 113 patients from the Reduction of infarct Expansion and Ventricular remodeling with Erythropoetin After Large myocardial infarction (REVEAL) trial, who underwent CMR within 4±2 days of revascularization...
2017: PloS One
https://www.readbyqxmd.com/read/28044391/initial-electrocardiogram-as-determinant-of-hospital-course-in-st-elevation-myocardial-infarction
#2
Michael A Millard, Vijaiganesh Nagarajan, Luke C Kohan, Robert C Schutt, Ellen C Keeley
BACKGROUND: A proportion of patients with ST elevation myocardial infarction (STEMI) have an initial electrocardiogram (ECG) that is nondiagnostic and are definitively diagnosed on a subsequent ECG. Our aim was to assess whether patients with a nondiagnostic initial ECG are different than those with a diagnostic initial ECG. METHODS: We collected demographic, ECG, medication, angiographic, and in-hospital clinical outcome data in consecutive patients undergoing primary percutaneous coronary intervention for STEMI at our institution from June 2009 to June 2013...
January 3, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28042584/st-elevation-myocardial-infarction-in-situs-inversus-dextrocardia-a-case-report
#3
Koh Keng Tat, Asri Said, Oon Yen Yee, Siti Nadia Binti Che Adinan, Ong Tiong Kiam
ST-elevation myocardial infarction (STEMI) in situs inversus dextrocardia is a rare combination and poses many challenges in terms of diagnosis and management. These include the early detection of dextrocardia as well as the interpretation of the ECG. In addition, percutaneous coronary intervention could be challenging in the setting of dextrocardia because of diffi culty in cannulating the coronary arteries, selection of catheters, catheter manipulation, image acquisition and interpretation.
December 2016: ASEAN Heart Journal: Official Journal of the ASEAN Federation of Cardiology
https://www.readbyqxmd.com/read/28040835/novel-ecg-changes-in-acute-coronary-syndromes-would-improvement-in-the-recognition-of-stemi-equivalents-affect-time-until-reperfusion
#4
Joshua Wall, Leigh D White, Astin Lee
Current guidelines recommend that patients with non-ST elevation myocardial infarction (NSTEMI) are treated with medical management alone, or in combination with coronary angiography within 24 h. Recent research suggests that NSTEMIs show angiographic evidence of complete occlusion at rates comparable to STEMIs, suggesting a subgroup of NSTEMI patients who require urgent angiography. Novel ECG changes, termed 'STEMI-equivalents', have been described as a way of identifying this subgroup. The aim of this study was to determine whether patients with STEMI-equivalent ECG changes experience similar degrees of myocardial damage, and would thus benefit from urgent PCI...
December 31, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28024553/sustained-performance-of-a-physicianless-system-of-automated-prehospital-stemi-diagnosis-and-catheterization-laboratory-activation
#5
Brian J Potter, Alexis Matteau, Samer Mansour, Charbel Naim, Mounir Riahi, Richard Essiambre, Martine Montigny, Isabelle Sareault, François Gobeil
BACKGROUND: Treatment times for primary percutaneous coronary intervention frequently exceed the recommended maximum delay. Automated "physicianless" systems of prehospital cardiac catheterization laboratory (CCL) activation show promise, but have been met with resistance over concerns regarding the potential for false positive and inappropriate activations (IAs). METHODS: From 2010 to 2015, first responders performed electrocardiograms (ECGs) in the field for all patients with a complaint of chest pain or dyspnea...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27970330/tct-162-the-glasgow-12-lead-ecg-analysis-algorithm-alone-is-not-suitable-for-pre-hospital-cardiac-catheter-laboratory-activation-for-stemi
#6
Amir Faour, Oliver Gibbs, Callum Cherrett, Karen Lintern, Christian Mussap, Rohan Rajaratnam, Craig Juergens, John French
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27968784/improving-stemi-screening-by-utilizing-a-diagnostic-ecg-algorithm-in-the-monitoring-environment
#7
Reza Firoozabadi, Richard E Gregg, Saeed Babaeizadeh
No abstract text is available yet for this article.
November 2016: Journal of Electrocardiology
https://www.readbyqxmd.com/read/27936877/-a-rare-ecg-manifestation-of-left-sided-pneumothorax-inferior-stemi-with-precordial-brugada-pattern
#8
Attila Frigy, Ildikó Kocsis, Lajos Fehérvári, Lehel Máthé
Recognition and identification of the cause of non-coronary ST elevation is important in daily practice, mainly for avoiding unnecessary diagnostic and therapeutic procedures. In this case, a rare cause, spontaneous, left sided tension pneumothorax was in the background of the suddenly appearing, complex ECG changes - ST elevation mimicking inferior wall myocardial infarction associated with type 1 Brugada pattern ("coved" ST-segment elevation ≥ 2 mm) in the precordial leads. The clinical picture and course, the differential diagnostic problems related to the case and the possible causes of the ECG changes will be presented...
December 2016: Orvosi Hetilap
https://www.readbyqxmd.com/read/27931763/usefulness-of-synthesized-18-lead-electrocardiography-in-the-diagnosis-of-st-elevation-myocardial-infarction-a-pilot-study
#9
Tadashi Ashida, Shigemasa Tani, Ken Nagao, Tsukasa Yagi, Naoya Matsumoto, Atsushi Hirayama
OBJECTIVE: This was a pilot retrospective case-series study performed to investigate whether synthesized 18-lead electrocardiogram (ECG) could improve the accuracy of infarction site diagnosis in patients presenting with ST-elevation myocardial infarction (STEMI). METHOD: Of 103 consecutive patients with acute coronary syndrome who underwent emergency coronary angiography between October 1, 2014 and December 10, 2015, 33 patients fulfilling the diagnostic criteria for STEMI were enrolled in this study...
November 25, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27928226/achieving-timely-percutaneous-reperfusion-for-rural-st-elevation-myocardial-infarction-patients-by-direct-transport-to-an-urban-pci-hospital
#10
Charles-Lwanga K Bennin, Saif Ibrahim, Farah Al-Saffar, Lyndon C Box, Joel A Strom
BACKGROUNDS: ST-elevation myocardial infarction (STEMI) guidelines recommend reperfusion by primary percutaneous coronary intervention (PCI) ≤ 90 min from time of first medical contact (FMC). This strategy is challenging in rural areas lacking a nearby PCI-capable hospital. Recommended reperfusion times can be achieved for STEMI patients presenting in rural areas without a nearby PCI-capable hospital by ground transportation to a central PCI-capable hospital by use of protocol-driven emergency medical service (EMS) STEMI field triage protocol...
October 2016: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/27914634/position-of-st-deviation-measurements-relative-to-the-j-point-impact-for-ischemia-detection
#11
Sumche Man, C Cato Ter Haar, Marjolein C de Jongh, Arie C Maan, Martin J Schalij, Cees A Swenne
BACKGROUND: There is no consensus about the time instant relative to the J point where ST deviation has to be measured for detection of acute ischemia in the ECG. METHODS: We analyzed 53 ECGs, recorded preceding emergency catheterization of acute coronary syndrome patients with a completely occluded culprit artery (cases), and 88 control ECGs recorded in the cardiology outpatient clinic. ECG-amplitude measurements were made every 10 ms, between 20 ms before till 80 ms after the J point...
January 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/27889057/algorithm-for-the-automatic-computation-of-the-modified-anderson-wilkins-acuteness-score-of-ischemia-from-the-pre-hospital-ecg-in-st-segment-elevation-myocardial-infarction
#12
Yama Fakhri, Maria Sejersten, Mikkel Malby Schoos, Jacob Melgaard, Claus Graff, Galen S Wagner, Peter Clemmensen, Jens Kastrup
BACKGROUND: The acuteness score (based on the modified Anderson-Wilkins score) estimates the acuteness of ischemia based on ST-segment, Q-wave and T-wave measurements obtained from the electrocardiogram (ECG) in patients with ST Elevation Myocardial Infarction (STEMI). The score (range 1 (least acute) to 4 (most acute)) identifies patients with substantial myocardial salvage potential regardless of patient reported symptom duration. However, due to the complexity of the score, it is not used in clinical practice...
January 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/27888672/incidence-of-coronary-intervention-in-cardiac-arrest-survivors-with-non-shockable-initial-rhythms-and-no-evidence-of-st-elevation-mi-stemi
#13
Matthew Wilson, Anne V Grossestreuer, David F Gaieski, Benjamin S Abella, William Frohna, Munish Goyal
OBJECTIVE: With the demonstrated benefit of an early-invasive strategy for STEMI and VF/VT arrest patients, there is interest in assessing the potential benefit of early angiography for non-shockable (PEA/Asystole) arrest patients. We hypothesized that in cardiac arrest patients who obtain return of spontaneous circulation (ROSC) after a non-shockable initial rhythm and do not have STEMI the incidence of coronary intervention would be clinically insignificant (<5%). METHODS: Retrospective multicenter US clinical registry study of post-cardiac arrest patients at 18 hospitals between 1/00 and 5/14...
November 23, 2016: Resuscitation
https://www.readbyqxmd.com/read/27887720/prehospital-electrocardiographic-acuteness-score-of-ischemia-is-inversely-associated-with-neurohormonal-activation-in-stemi-patients-with-severe-ischemia
#14
Yama Fakhri, Mikkel Malby Schoos, Maria Sejersten, Mads Ersbøll, Nana Valeur, Lars Køber, Christian Hassager, Galen S Wagner, Jens Kastrup, Peter Clemmensen
BACKGROUND: Elevated levels of N-terminal pro brain natriuretic peptide (NT-proBNP) are associated with adverse cardiovascular outcome after ST elevation myocardial infarction (STEMI). We hypothesized that decreasing acuteness-score (based on the electrocardiographic score by Anderson-Wilkins acuteness score of myocardial ischemia) is associated with increasing NT-proBNP levels and the impact of decreasing acuteness-score on NT-proBNP levels is substantial in STEMI patients with severe ischemia...
January 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/27858506/causes-of-prehospital-misinterpretations-of-st-elevation-myocardial-infarction
#15
Nichole Bosson, Stephen Sanko, Ronald E Stickney, James Niemann, William J French, James G Jollis, Michael C Kontos, Tyson G Taylor, Peter W Macfarlane, Richard Tadeo, William Koenig, Marc Eckstein
OBJECTIVES: To determine the causes of software misinterpretation of ST elevation myocardial infarction (STEMI) compared to clinically identified STEMI to identify opportunities to improve prehospital STEMI identification. METHODS: We compared ECGs acquired from July 2011 through June 2012 using the LIFEPAK 15 on adult patients transported by the Los Angeles Fire Department. Cases included patients ≥18 years who received a prehospital ECG. Software interpretation of the ECG (STEMI or not) was compared with data in the regional EMS registry to classify the interpretation as true positive (TP), true negative (TN), false positive (FP), or false negative (FN)...
November 18, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27796707/comparison-of-clinical-based-and-ecg-based-triage-of-acute-chest-pain-in-the-emergency-department
#16
Melanie Dechamps, Diego Castanares-Zapatero, Patrick Vanden Berghe, Philippe Meert, Alessandro Manara
In the Emergency Department, chest pain triage systems are based on either clinical features or ECG recording. In this prospective, single-center, observational study, we aimed to compare the diagnostic performance of these triage systems in distinguishing acute coronary syndromes (ACS) from diseases of mild severity. Patients were sorted into the triage systems based on collected data at admission and on a systematic 12-lead ECG performed at triage. The final diagnosis was determined after a 30-day follow-up...
October 28, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27759433/emergency-physician-accuracy-in-interpreting-electrocardiograms-with-potential-st-segment-elevation-myocardial-infarction-is-it-enough
#17
Giacomo Veronese, Federico Germini, Stella Ingrassia, Ombretta Cutuli, Valeria Donati, Luca Bonacchini, Maura Marcucci, Andrea Fabbri
BACKGROUND: Electrocardiogram (ECG) interpretation is widely performed by emergency physicians. We aimed to determine the accuracy of interpretation of potential ST-segment elevation myocardial infarction (STEMI) ECGs by emergency physicians. METHODS: Thirty-six ECGs resulted in putative STEMI diagnoses were selected. Participants were asked to focus on whether or not the ECG in question met the diagnostic criteria for an acutely blocked coronary artery causing a STEMI...
October 19, 2016: Acute Cardiac Care
https://www.readbyqxmd.com/read/27757473/-typical-atypical-ecgs-and-anterior-wall-infarction-subtle-signs-of-an-acute-coronary-artery-occlucion
#18
S Grautoff
The ECG is a very important diagnostic tool if an acute coronary syndrome is suspected. It should be performed immediately when medical staff contacts the patient. If an ST elevation myocardial infarction (STEMI) is diagnosed, immediate reperfusion of the occluded vessel should be the primary goal. Therefore, even subtle signs of an anterior wall infarction diagnosed by the ECG which lead to suspicion of complete occlusion of a coronary artery should be known and diagnosed by all physicians who may have contact with these types of patients...
October 18, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/27751282/spontaneous-psoas-hematoma-in-a-case-of-acute-myocardial-infarction-following-streptokinase-infusion
#19
B Sunil Abhishek, Sai C Vijay, V Avanthi, B Kumar
INTRODUCTION: Cardiovascular disorders are the major cause of mortality and morbidity globally as well as in India. In India, where resources are limited and majority of patients pay out of their own pocket, thrombolysis is still done for majority of STEMI cases. CASE SCENARIO: A 48-year-old male patient, nonhypertensive and nondiabetic, came to the ER with history of retrosternal chest pain suggestive of angina at rest. An Electrocardiogram (ECG) revealed ST-segment elevation in the anterior leads...
September 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27741130/proximal-complete-occlusion-of-right-coronary-artery-presenting-with-precordial-st-segment-elevation-a-case-report
#20
Jianlei Zheng, Jingyang Lin, Naiji Shen, Baiming Qu
BACKGROUND: It is well known that cardiologists empirically judge the culprit lesion of acute ST-segment elevation myocardial infarction (STEMI) according to the corresponding electrocardiographic leads. However, In addition to the obstruction of left anterior descending (LAD) coronary artery, rare cases with the occlusion of proximal right coronary artery (RCA) and/or isolated right ventricular (RV) branch showed the ST-segment elevation in precordial leads V1-V3 as well. CASE SUMMARY: We reported a patient complaining of acute chest pain and suffering ventricular fibrillation (VF) on admission...
October 2016: Medicine (Baltimore)
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