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STEMI ECG

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https://www.readbyqxmd.com/read/29153151/what-is-the-best-st-segment-recovery-parameter-to-predict-clinical-outcome-and-myocardial-infarct-size-amplitude-speed-and-completeness-of-st-segment-recovery-after-primary-percutaneous-coronary-intervention-for-st-segment-elevation-myocardial-infarction
#1
Wichert J Kuijt, Cindy L Green, Niels J W Verouden, Joost D E Haeck, Dan Tzivoni, Karel T Koch, Gregg W Stone, Alexandra J Lansky, Samuel Broderick, Jan G P Tijssen, Robbert J de Winter, Matthew T Roe, Mitchell W Krucoff
AIMS: ST-segment recovery (STR) is a strong mechanistic correlate of infarct size (IS) and outcome in ST-segment elevation myocardial infarction (STEMI). Characterizing measures of speed, amplitude, and completeness of STR may extend the use of this noninvasive biomarker. METHODS AND RESULTS: Core laboratory continuous 24-h 12-lead Holter ECG monitoring, IS by single-photon emission computed tomography (SPECT), and 30-day mortality of 2 clinical trials of primary percutaneous coronary intervention in STEMI were combined...
November 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29121757/association-between-qrs-duration-on-prehospital-ecg-and-mortality-in-patients-with-suspected-stemi
#2
Rikke Hansen, Martin Frydland, Ole Kristian Møller-Helgestad, Matias Greve Lindholm, Lisette Okkels Jensen, Lene Holmvang, Hanne Berg Ravn, Jesper Kjærgaard, Christian Hassager, Jacob Eifer Møller
BACKGROUND: QRS duration has previously shown association with mortality in patients with acute myocardial infarction treated with thrombolytics, less is known in patients with suspected ST segment elevation myocardial infarction (STEMI) when assessing QRS duration on prehospital ECG. Thus, the objective was to investigate the prognostic effect of QRS duration on prehospital ECG and presence of classic left and right bundle branch block (LBBB/RBBB) for all-cause mortality in patients with suspected STEMI...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29108788/peri-procedural-st-segment-resolution-during-primary-percutaneous-coronary-intervention-ppci-for-acute-myocardial-infarction-predictors-and-clinical-consequences
#3
Grigoris V Karamasis, Paul Russhard, Firas Al Janabi, Michael Parker, John R Davies, Thomas R Keeble, Gerald J Clesham
OBJECTIVE: ECG ST segment resolution (STR) has been used to assess myocardial perfusion in STEMI patients undergoing PPCI. However, in most of the studies ECGs recorded at different time points after the actual procedure have been used, limiting the options of therapeutic interventions while the patient is still in the catheterisation laboratory. The aim of this study was to investigate the presence and clinical consequences of intra-procedural STR during PPCI. METHODS: We analysed 12 lead ECGs recorded at the onset and the end of the PPCI procedure, measuring STR in the lead with maximum ST elevation on the initial recording...
October 5, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29064258/new-or-presumed-new-left-bundle-branch-block-in-patients-with-suspected-st-elevation-myocardial-infarction
#4
Vijaya K Pera, David M Larson, Scott W Sharkey, Ross F Garberich, Christopher J Solie, Yale L Wang, Jay H Traverse, Anil K Poulose, Timothy D Henry
AIMS: Using a comprehensive large prospective regional ST-elevation myocardial infarction (STEMI) system database, we evaluated the prevalence, clinical and angiographic characteristics, and outcomes in patients with ischemic symptoms and new or presumed new left bundle branch block (LBBB). We then tested a new hierarchical diagnosis and triage algorithm to identify more accurately new LBBB patients with an acute culprit lesion. METHODS AND RESULTS: From March 2003 to June 2013, 3903 consecutive STEMI patients were treated using the Minneapolis Heart Institute regional STEMI protocol including 131 patients (3...
February 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29054179/the-impact-of-systems-of-care-on-pharmacoinvasive-management-with-streptokinase-the-subgroup-analysis-of-the-tn-stemi-programme
#5
Deep Chandh Raja, Vijayakumar Subban, Suma M Victor, George Joseph, Viji Samuel Thomson, Kumaresan Kannan, Justin Paul Gnanaraj, Ganesh Veerasekar, Jose G Thenpally, Nandhini Livingston, Brahmajee K Nallamothu, Thomas Alexander, Ajit S Mullasari
OBJECTIVES: We evaluated the impact of implementation of the TN-STEMI programme on various characteristics of the pharmacoinvasive group by comparing clinical as well as angiographic outcomes between the pre- and post-implementation groups. METHODS: The TN-STEMI programme involved 2420 patients of which 423 patients had undergone a pharmacoinvasive strategy of reperfusion. Of these, 407 patients had a comprehensive blinded core-lab evaluation of their angiograms post-lysis and clinical evaluation of various parameters including time-delays and adverse cardio- and cerebro-vascular events at 1year...
September 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/29050736/-complicated-transcatheter-aortic-valve-endocarditis-with-abscess-and-pseudoaneurysm-value-of-the-ecg-gated-multidetector-computed-tomography-angiography
#6
S Pichard, G Gibault-Genty, A Vienet-Legue, N Baron, R Convers-Domart, J L Georges, B Livarek
A 80-year-old man was admitted to catheterization room for an acute infero-lateral ST-elevation myocardial infarction (STEMI). Coronary angiography showed a thrombotic occlusion of the second left marginal branch, and normal other coronary arteries. The thrombo-embolic mechanism of the STEMI, and the infectious context in this patient who had had a transcatheter aortic valve implantation (TAVI) two months earlier, led us to suspect a bioprosthesis endocarditis. It was confirmed by transthoracic and transoesophageal echocardiography, which showed an aortic-mitral curtain abscess and aortic bioprosthesis vegetations, associated to Enterococcus faecalis bacteriemia...
November 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/29033166/early-peripheral-endothelial-dysfunction-predicts-myocardial-infarct-extension-and-microvascular-obstruction-in-patients-with-st-elevation-myocardial-infarction
#7
Sérgio Bravo Baptista, Mariana Faustino, Luís Brizida, José Loureiro, João Augusto, João Abecasis, Célia Monteiro, Paulo Leal, Maura Nédio, Pedro Farto E Abreu, Victor Gil, Carlos Morais
INTRODUCTION AND OBJECTIVES: The role of endothelial dysfunction (ED) in patients with ST-elevation myocardial infarction (STEMI) is poorly understood. Peripheral arterial tonometry (PAT) allows non-invasive evaluation of ED, but has never been used for this purpose early after primary percutaneous coronary intervention (P-PCI). Our purpose was to analyze the relation between ED assessed by PAT and both the presence of microvascular obstruction (MVO) and infarct extension in STEMI patients...
October 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29021273/improvement-in-care-and-outcomes-for-emergency-medical-service-transported-patients-with-st-elevation-myocardial-infarction-stemi-with-and-without-prehospital-cardiac-arrest-a-mission-lifeline-stemi-accelerator-study
#8
Kristian Kragholm, Di Lu, Karen Chiswell, Hussein R Al-Khalidi, Mayme L Roettig, Matthew Roe, James Jollis, Christopher B Granger
BACKGROUND: Patients with ST-elevation myocardial infarction (STEMI) with out-of-hospital cardiac arrest (OHCA) may benefit from direct transport to a percutaneous cardiac intervention (PCI) hospital but have previously been less likely to bypass local non-PCI hospitals to go to a PCI center. METHODS AND RESULTS: We reported time trends in emergency medical service transport and care of patients with STEMI with and without OHCA included from 171 PCI-capable hospitals in 16 US regions with participation in the Mission: Lifeline STEMI Accelerator program between July 1, 2012, and March 31, 2014...
October 11, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28994853/akut-ocklusion-av-cirkumflexa-kransart%C3%A3-ren-sv%C3%A3-r-att-uppt%C3%A3-cka-viktigt-att-titta-i-%C3%A2-d%C3%A3-da-vinkeln%C3%A2-p%C3%A3-ekg
#9
Thomas Lindow, Kjell Nikus, Olle Pahlm
Acute occlusion of the left circumflex coronary artery - in the »blind spot« of the ECG? Acute coronary artery occlusion should be treated with urgent revascularization. ECG is important in the triage of patients with acute coronary syndrome. ST deviation depends on the relation between the location of the transmural ischemia and the positive poles of the 12 ECG leads. In acute occlusion of the left circumflex artery, ST elevation in two contiguous leads is not always present. Instead, isolated ST depression in leads V1-V3 may be present and represents a »STEMI-equivalent« pattern...
October 10, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28971117/data-on-association-between-qrs-duration-on-prehospital-ecg-and-mortality-in-patients-with-confirmed-stemi
#10
Rikke Hansen, Martin Frydland, Ole Kristian Møller-Helgestad, Matias Greve Lindholm, Lisette Okkels Jensen, Lene Holmvang, Hanne Berg Ravn, Jesper Kjærgaard, Christian Hassager, Jacob Eifer Møller
Data presented in this article relates to the research article entitled "Association between QRS duration on prehospital ECG and mortality in patients with suspected STEMI" (Hansen et al., in press) [1]. Data on the prognostic effect of automatically recoded QRS duration on prehospital ECG and presence of classic left and right bundle branch block in 1777 consecutive patients with confirmed ST segment elevation AMI is presented. Multivariable analysis, suggested that QRS duration >111 ms, left bundle branch block and right bundle branch block were independent predictors of 30 days all-cause mortality...
December 2017: Data in Brief
https://www.readbyqxmd.com/read/28959003/st-elevation-myocardial-infarction-due-to-left-anterior-descending-artery-occlusion-presenting-primarily-with-otalgia
#11
Elhaitham K Ahmed, M Salim Alkodaymi, Mohammed Mohammed Soliman, Asaad Suliman Shujaa
BACKGROUND Myocardial infarction (MI) is one of the most serious conditions presenting to the Emergency Department. Typical/classical symptoms of MI include chest pain and tightness that is referred to the left arm. CASE REPORT We present a case of ST-elevation myocardial infarction (STEMI) with a primary atypical presentation of right ear pain. The patient was diagnosed with STEMI based on electrocardiogram (ECG) and cardiac markers. As a result, the patient underwent percutaneous intervention (PCI), which showed an occluded left anterior descending artery (LAD) compared to the previous reported studies with similar presentation in which the right coronary artery (RCA) was affected...
September 29, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28943533/incidence-and-significance-of-spontaneous-st-segment-re-elevation-after-reperfused-anterior-acute-myocardial-infarction%C3%A3-relationship-with-infarct-size-adverse-remodeling-and-events-at-1-year
#12
Léo Cuenin, Sophie Lamoureux, Mathieu Schaaf, Thomas Bochaton, Jean-Pierre Monassier, Marc J Claeys, Gilles Rioufol, Gérard Finet, David Garcia-Dorado, Denis Angoulvant, Meyer Elbaz, Nicolas Delarche, Pierre Coste, Marc Metge, Thibault Perret, Pascal Motreff, Eric Bonnefoy-Cudraz, Gérald Vanzetto, Olivier Morel, Inesse Boussaha, Michel Ovize, Nathan Mewton
BACKGROUND: Up to 25% of patients with ST elevation myocardial infarction (STEMI) have ST segment re-elevation after initial regression post-reperfusion and there are few data regarding its prognostic significance.Methods and Results:A standard 12-lead electrocardiogram (ECG) was recorded in 662 patients with anterior STEMI referred for primary percutaneous coronary intervention (PPCI). ECGs were recorded 60-90 min after PPCI and at discharge. ST segment re-elevation was defined as a ≥0...
September 23, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28936441/correlation-between-electrocardiographic-changes-and-coronary-findings-in-patients-with-acute-myocardial-infarction-and-single-vessel-disease
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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...
November 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
#19
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
#20
MULTICENTER STUDY
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...
October 2017: Canadian Journal of Cardiology
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