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STEMI ECG

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https://www.readbyqxmd.com/read/28264870/association-between-early-q-waves-and-reperfusion-success-in-patients-with-st-segment-elevation-myocardial-infarction-treated-with-primary-percutaneous-coronary-intervention-a-cardiac-magnetic-resonance-imaging-study
#1
Divan Gabriel Topal, Jacob Lønborg, Kiril Aleksov Ahtarovski, Lars Nepper-Christensen, Steffen Helqvist, Lene Holmvang, Frants Pedersen, Peter Clemmensen, Kari Saünamaki, Erik Jørgensen, Kasper Kyhl, Ali Ghotbi, Mikkel Malby Schoos, Christoffer Göransson, Litten Bertelsen, Dan Høfsten, Lars Køber, Henning Kelbæk, Niels Vejlstrup, Thomas Engstrøm
BACKGROUND: Pathological early Q waves (QW) are associated with adverse outcomes in patients with ST-segment-elevation myocardial infarction (STEMI). Primary percutaneous coronary intervention (PCI) may therefore be less beneficial in patients with QW than in patients without QW. Myocardial salvage index and microvascular obstruction (MVO) are markers for reperfusion success. Thus, to clarify the benefit from primary PCI in STEMI patients with QW, we examined the association between baseline QW and myocardial salvage index and MVO in STEMI patients treated with primary PCI...
March 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28261908/acute-coronary-syndrome-screening-and-diagnostic-practice-variation
#2
Maame Yaa A B Maya Yiadom, Xulei Liu, Conor M McWade, Dandan Liu, Alan B Storrow
BACKGROUND: In the absence of the existing acute coronary syndrome guidelines directing the clinical practice implementation of ED screening and diagnosis, there is variable screening and diagnostic clinical practice across ED facilities. This practice diversity may be warranted. Understanding the variability may identify opportunities for more consistent practice. METHODS: This is a cross-sectional clinical practice epidemiology study with the emergency department (ED) as the unit of analysis characterizing variability in the acute coronary syndrome (ACS) evaluation across 62 diverse EDs...
March 6, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28250684/acute-st-segment-elevation-myocardial-infarction-the-prognostic-importance-of-lead-augmented-vector-right-and-leads-v7-v9
#3
Veeresh Patil Hebbal, Huliyurdurga Srinivasasetty Natraj Setty, Cholenahalli Manjunath Sathvik, Vikram Patil, Sarthak Sahoo, Cholenahalli Nanjappa Manjunath
BACKGROUND: Acute myocardial infarction (MI) is associated with high mortality and among survivors have high morbidity. Electrocardiogram (ECG), a cost-effective and easily available, has traditionally been used not only just for diagnosis of MI but also for culprit vessel recognition and for prognostication. However, the role of lead augmented vector right (aVR) and leads V7-V9 in acute MI are often neglected in clinical practice. We studied the role of lead aVR and leads V7-V9 in ST-elevation MI (STEMI) patients...
January 2017: Journal of Natural Science, Biology, and Medicine
https://www.readbyqxmd.com/read/28244599/fragmented-qrs-complex-predicts-contrast-induced-nephropathy-and-in-hospital-mortality-after-primary-percutaneous-coronary-intervention-in-patients-with-st-segment-elevation-myocardial-infarction
#4
Alparslan Kurtul, Mustafa Duran
BACKGROUND: Contrast-induced nephropathy (CIN) is associated with increased mortality after primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). Recently, fragmented QRS complex (fQRS) on 12-lead electrocardiography has been introduced as a marker of cardiovascular disease and is associated with increased morbidity and mortality. HYPOTHESIS: fQRS on ECG is associated with CIN and in-hospital mortality after primary PCI in patients with STEMI...
February 28, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28243396/morphine-post-conditioning-effect-on-qt-dispersion-in-patients-undergoing-primary-percutaneous-coronary-intervention-on-anterior-descending-cardiac-artery-a-cohort-study
#5
Ali Eshraghi, Mohammad Tayyebi, Seyed Sajed Sajjadi, Ramin Khameneh Bagheri, Reyhaneh Takalloo Ebdali, Reza Golnezhad
INTRODUCTION: QT dispersion is the difference between the maximum and minimum QTc interval in a 12-lead electrocardiogram (ECG). Some researchers have demonstrated the effects of an increase of QT-d in STEMI and its reduction with successful therapy. The aim of this study was to investigate the morphine post-conditioning effect on the QT dispersion in patients undergoing primary percutaneous coronary intervention (PCI) on anterior descending cardiac artery. METHODS: This cohort study was conducted on STEMI patients admitted to the Hospital of Imam Reza (AS), Mashhad, Iran, from March 2015 to February 2016 who were undergoing primary angioplasty on the anterior descending cardiac artery...
January 2017: Electronic Physician
https://www.readbyqxmd.com/read/28197284/st-segment-elevation-myocardial-infarction-door-to-balloon-time-improvement-project
#6
Saad Al Bugami, Jamilah Alrahimi, Abdullah Almalki, Farqad Alamger, Ahmed Krimly, Wail Al Kashkari
BACKGROUND: The purpose of this quality improvement project was to evaluate prospectively the causes of delay for patients with acute ST-segment elevation myocardial infarction (STEMI) requiring primary percutaneous coronary intervention (PCI) upon arrival at the emergency department (ED) and implement recommendations to reduce delays and analyze the impact of recommendations to reduce the door-to-balloon (D2B) time in a newly established cardiac center (King Faisal Cardiac Center (KFCC))...
August 2016: Cardiology Research
https://www.readbyqxmd.com/read/28124201/hyperkalemia-masked-by-pseudo-stemi-infarct-pattern-and-cardiac-arrest
#7
Shareez Peerbhai, Luke Masha, Adrian DaSilva-DeAbreu, Abhijeet Dhoble
BACKGROUND: Hyperkalemia is a common electrolyte abnormality and has well-recognized early electrocardiographic manifestations including PR prolongation and symmetric T wave peaking. With severe increase in serum potassium, dysrhythmias and atrioventricular and bundle branch blocks can be seen on electrocardiogram. Although cardiac arrest is a worrisome consequence of untreated hyperkalemia, rarely does hyperkalemia electrocardiographically manifest as acute ischemia. CASE PRESENTATION: We present a case of acute renal failure complicated by malignant hyperkalemia and eventual ventricular fibrillation cardiac arrest...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28121344/impact-of-myocardial-blush-grade-on-tpe-interval-and-tpe-qt-ratio-after-successful-primary-percutaneous-coronary-intervention-in-patients-with-st-elevation-myocardial-infarction
#8
P T Duyuler, S Duyuler, M Demir
INTRODUCTION: Myocardial perfusion, when assessed by myocardial blush grade (MBG) is an independent predictor of major adverse cardiac outcomes. The terminal part of repolarization, measured as the interval from the peak to the end of the T wave (Tpe), is a relatively novel indicator of ventricular arrhythmias. The relations between MBG and Tpe interval have not been examined before. We aimed to evaluate the relationship between MBG and Tpe and Tpe/QT ratio after successful primary percutaneous coronary intervention (PCI) in acute ST-segment elevation myocardial infarction (STEMI)...
January 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28114719/-right-bundle-branch-block-left-bundle-branch-block-pace-maker-in-case-of-acute-coronary-syndrome-is-the-ecg-of-any-value
#9
REVIEW
Steffen Grautoff
The 12 lead ECG is difficult to evaluate if there is a persistent right or even left bundle block or a pace maker continually stimulating the right ventricle. Despite these pre-existing or new ECG changes it might still be possible to detect variations which can hint to an ST-elevation myocardial infarction (STEMI). Diagnosing significant ST elevations in a case of right bundle block is not very challenging. If the ECG shows a left bundle block the modified Sgarbossa criteria should be used for evaluation. These criteria can also be used in a pace maker ECG...
January 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28111177/characteristics-and-survival-determinants-in-patients-after-out-of-hospital-cardiac-arrest-in-the-era-of-24-7-coronary-intervention-facilities
#10
Josef Kroupa, Jiri Knot, Jaroslav Ulman, Frantisek Bednar, Alena Dohnalova, Zuzana Motovska
BACKGROUND: Survival rates and outcomes after out-of-hospital cardiac arrest (OHCA) remain low despite investments of time and money. The goal of this analysis was to identify variables related to survival of patients transferred to our coronary care unit (CCU) after an OHCA. METHODS: 102 consecutive OHCA patients, mean age 64.6 (SD 13.3), 70.6% men, between January, 2011 and December, 2013, who were transferred to our tertiary care CCU, were studied. RESULTS: Cardiac-cause OHCA was present in 84 patients (82...
December 24, 2016: Heart, Lung & Circulation
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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-stemitoc-and-title-pages
#19
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...
March 2017: 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
#20
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
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