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STEMI ECG

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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
#1
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...
November 10, 2016: 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
#2
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
#3
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...
November 10, 2016: Journal of Electrocardiology
https://www.readbyqxmd.com/read/27858506/causes-of-prehospital-misinterpretations-of-st-elevation-myocardial-infarction
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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)
https://www.readbyqxmd.com/read/27727980/the-role-of-ecg-in-localizing-culprit-vessel-in-acute-stemi-with-echocardiographic-correlation
#10
Varun Sharma, M H Usmani, K D Singh, R P Singh
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27727576/role-of-ecg-in-identification-of-culprit-vessel-occlusion-in-acute-stemi-in-relation-to-angiography
#11
Salunke Kk, Khyalappa Rj
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27699259/microvascular-resistance-of-the-culprit-coronary-artery-in-acute-st-elevation-myocardial-infarction
#12
David Carrick, Caroline Haig, Jaclyn Carberry, Vannesa Teng Yue May, Peter McCartney, Paul Welsh, Nadeem Ahmed, Margaret McEntegart, Mark C Petrie, Hany Eteiba, Mitchell Lindsay, Stuart Hood, Stuart Watkins, Ahmed Mahrous, Samuli M O Rauhalammi, Ify Mordi, Ian Ford, Aleksandra Radjenovic, Naveed Sattar, Keith G Oldroyd, Colin Berry
BACKGROUND: Failed myocardial reperfusion is common and prognostically important after acute ST-elevation myocardial infarction (STEMI). The purpose of this study was to investigate coronary flow reserve (CFR), a measure of vasodilator capacity, and the index of microvascular resistance (IMR; mmHg × s) in the culprit artery of STEMI survivors. METHODS: IMR (n = 288) and CFR (n = 283; mean age [SD], 60 [12] years) were measured acutely using guide wire-based thermodilution...
May 5, 2016: JCI Insight
https://www.readbyqxmd.com/read/27677377/an-evaluation-of-pre-hospital-emergency-medical-systems-for-suspected-st-elevation-myocardial-infarction-in-colorado
#13
Glenn H Engelman, Patrick M Carry, Kyle M Kubes, Michael J Gleason
OBJECTIVES: Patients presenting with ST-elevation myocardial infarction (STEMI) benefit from rapid cardiac reperfusion therapy. Emergency medical service (EMS) agencies can improve patient outcomes by calling STEMI alerts to the receiving facility. The aim of this study was to evaluate the use of pre-hospital activation systems for suspected ST-elevation myocardial infarctions (STEMI) throughout Colorado. METHODS: A cross sectional, survey design was utilized to collect all data from EMS agencies in Colorado...
November 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27667713/high-sensitivity-troponin-t-as-a-prognostic-marker-after-out-of-hospital-cardiac-arrest-a-targeted-temperature-management-ttm-trial-substudy
#14
Patrik Gilje, Sasha Koul, Jakob Hartvig Thomsen, Yvan Devaux, Hans Friberg, Michael Kuiper, Janneke Horn, Niklas Nielsen, Tomasso Pellis, Pascal Stammet, Matthew P Wise, Jesper Kjaergaard, Christian Hassager, David Erlinge
AIM OF THE STUDY: Predicting outcome of unconscious patients after successful resuscitation is challenging and better prognostic markers are highly needed. Ischemic heart disease is a common cause of out-of-hospital cardiac arrest (OHCA). Whether or not high-sensitivity troponin T (hs-TnT) is a prognostic marker among survivors of OHCA with both ischemic and non-ischemic aetiologies remains to be determined. We sought to evaluate the ability of hs-TnT to prognosticate all-cause mortality, death due to cardiovascular causes or multi-organ failure and death due to cerebral causes after OHCA...
October 2016: Resuscitation
https://www.readbyqxmd.com/read/27662776/validation-of-the-vessel-specific-leads-vsls-for-detection-of-acute-ischemia-on-a-dataset-with-non-ischemic-st-segment-deviation
#15
John J Wang, Olle Pahlm, Galen S Wagner, James W Warren, B Milan Horáček, John L Sapp
BACKGROUND: Existing criteria recommended by ACC/ESC for identifying patients with ST elevation myocardial infarction (STEMI) from the 12-lead ECG perform with high specificity (SP) but low sensitivity (SE). In our previous studies, we found that the SE of acute ischemia detection can be markedly improved without any loss of SP by calculating, from the 12-lead ECG, ST deviation in 3 "optimal" vessel-specific leads (VSLs). To further validate the method, we evaluated the SP performance using a dataset with non-ischemic ST-segment changes...
August 18, 2016: Journal of Electrocardiology
https://www.readbyqxmd.com/read/27640933/patients-without-st-elevation-after-return-of-spontaneous-circulation-may-benefit-from-emergent-percutaneous-intervention-a-systematic-review-and-meta-analysis
#16
Michael G Millin, Angela C Comer, Jose V Nable, Peter V Johnston, Benjamin J Lawner, Nathan Woltman, Matthew J Levy, Kevin G Seaman, Jon Mark Hirshon
INTRODUCTION: The American Heart Association recommends that post-arrest patients with evidence of ST elevation myocardial infarction (STEMI) on electrocardiogram (ECG) be emergently taken to the catheterization lab for percutaneous coronary intervention (PCI). However, recommendations regarding the utility of emergent PCI for patients without ST elevation are less specific. This review examined the literature on the utility of PCI in post-arrest patients without ST elevation compared to patients with STEMI...
September 15, 2016: Resuscitation
https://www.readbyqxmd.com/read/27618475/smith-modified-sgarbossa-criteria-and-paced-rhythms-a%C3%A2-case-report
#17
Nana Sefa, Kelly N Sawyer
BACKGROUND: As the incidence of left bundle branch blocks (LBBBs) and paced-rhythms electrocardiograms (ECGs) increase in the aging global population, the need for rapid and accurate diagnosis of ST-elevation myocardial infarction (STEMI) or STEMI equivalents in patients with these rhythms becomes more imperative. The Sgarbossa and Smith-modified Sgarbossa criteria have been documented to enhance the diagnosis of STEMI in the setting of LBBBs. However, there is a growing body of literature that suggests that these criteria can also be applied for the diagnosis of STEMI in patients with paced rhythms...
September 8, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27586500/association-of-the-right-ventricle-impairment-with-electrocardiographic-localization-and-related-artery-in-patients-with-st-elevation-myocardial-infarction
#18
Jan Kanovsky, Petr Kala, Tomas Novotny, Klara Benesova, Maria Holicka, Jiri Jarkovsky, Lumir Koc, Monika Mikolaskova, Tomas Ondrus, Marek Malik
INTRODUCTION: The right ventricular myocardial infarction (RVMI) has traditionally been mainly related to inferior wall ST elevation myocardial infarction (STEMI). This study assessed the RVMI electrocardiographic (ECG-RVMI) signs in relationship to ECG-based STEMI localization and to the infarct related artery in patients treated with primary percutaneous coronary intervention (pPCI). METHODS: Three hundred consecutive adult patients (107 females) were referred to catheterization laboratory with the acute STEMI diagnosis...
August 5, 2016: Journal of Electrocardiology
https://www.readbyqxmd.com/read/27570759/validity-and-utility-of-icd-10-administrative-health-data-for-identifying-st-and-non-st-elevation-myocardial-infarction-based-on-physician-chart-review
#19
Alka B Patel, Hude Quan, Robert C Welsh, Jessica Deckert-Sookram, Wayne Tymchak, Sunil Sookram, Ian Surdhar, Padma Kaul
BACKGROUND: Health care administrative databases are useful for assessing the population-level burden of disease and examining issues related to access, costs and quality of care. In these databases, the diagnoses and procedures are coded with the use of the World Health Organization International Classification of Diseases (ICD). We examined the validity of 2 ICD-10 coding definitions for categorizing patients with acute myocardial infarction (MI) as having ST-elevation MI (STEMI) or non-ST-elevation MI (non-STEMI)...
October 2015: CMAJ Open
https://www.readbyqxmd.com/read/27552568/concomitant-measurements-of-serum-annexin-a5-levels-and-hematological-indices-as-markers-in-recent-and-old-myocardial-infarction-with-low-ejection-fraction-a-preliminary-study
#20
Adil Hassan Alhusseiny, Marwan S M Al-Nimer, Farook I Mohammad, Saad Ahmed Ali Jadoo
BACKGROUND: Serum annexin A5 (anxA5) level is significantly increased in patients with acute coronary syndrome. Hematological indices are significantly increased in patients with ischemic heart disease. This study aimed to demonstrate the changes in the distribution of blood cells and the levels of anxA5 in patients presented with significant low ejection fraction ST-elevation acute myocardial infarction (STEMI) in comparison with corresponding patients with ischemic heart disease. METHODS: Patients with low ejection fraction presenting at Hospital of Diyala University of Iraq were enrolled...
November 15, 2016: International Journal of Cardiology
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