Electrocardiography

Gorgels, Anton P.M.

doi:10.1007/978-1-84628-715-2_3

Cited by 12 publications

(5 citation statements)

References 49 publications

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“…The direction of ST-segment deviation indicates the occlusion site in the coronary artery (figure 1). [16][17][18][19] To differentiate lesions in the proximal and distal right coronary artery and the circumflex artery 11,12 lead V4R was recorded instead of lead V4, after we found that ST deviation in lead V4 is the mean of ST deviations in leads V3 and V5. Apart from ST-segment deviation measurement (elevated, isoelectric or depressed) in the individual lead, the sum of deviations in all leads was determined and measured in mm's, resulting in the total ST-segment deviation score.…”

Section: -16mentioning

confidence: 99%

The value of the ECG for decision-making at first medical contact in the patient with acute chest pain

Meißner

Trappe²,

Boer³

et al. 2010

NHJL

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Background/Objectives. Rapid risk stratification of the patient with acute chest pain is essential to select the best management. We investigated the value of the ECG at first medical contact to determine size of the ischaemic myocardial area and thereby severity of risk.Methods. In 386 patients with acute chest pain, ECG findings were correlated with the coronary angiogram. Using ST-segment deviation patterns the location of the coronary culprit lesion was predicted and thereby size of the area at risk. Four groups of patients were present. Those with a narrow QRS and a total 12-lead ST-segment deviation score of >/=5 mm (group 1) or /=120 ms (group 3), and patients with previous coronary bypass grafting (CABG) or percutaneous coronary intervention (PCI) (group 4).Results. Correct coronary culprit lesion localisation was possible in 84% of the 185 patients in group 1, 40% of the total cohort. Accurate prediction was not possible in most patients in groups 2, 3 and 4, in spite of extensive coronary artery disease in group 3 and 4. Conclusions. Using the 12-lead ECG the size of the myocardial area at risk can be accurately predicted when the total ST-segment deviation score is >/=5 mm, allowing identification of those in need of a PCI. In most patients with bundle branch block, previous CABG or PCI, the ECG can not localise the culprit lesion. This approach simplifies and accelerates decision-making at first medical contact. (Neth Heart J 2010;18:301-6.).

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Section: -16mentioning

confidence: 99%

The value of the ECG for decision-making at first medical contact in the patient with acute chest pain

Meißner

Trappe²,

Boer³

et al. 2010

NHJL

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“…Two major questions remain unanswered: (1) can we exclude STEMI equivalent if ST depression extends beyond V4 (into V5-V6)? (2) how to diagnose inferolateral STEMI-equivalent in patients with right bundle branch (that often causes ST depression in leads V1-V3).…”

Section: St Depression In Leads V1-v4mentioning

confidence: 99%

The Electrocardiogram in Coronary Artery Disease

Birnbaum

Wilson

Nikus

2015

Coronary Artery Disease

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The fi rst human electrocardiogram (ECG) was performed by AD Waller in 1887. Willem Einthoven was the fi rst one to use the term ECG in 1901 and named the waves P, Q, R, S and T. The ECG remains a major non-invasive cardiac imaging tool. In the last 30 years newer and more direct imaging modalities, such as echocardiography, nuclear scanning, cardiac computerized tomography (CT) and magnetic resonance imaging (MRI) have been developed, adding to the information gained from the ECG in the assessment of the heart in various stable conditions. Yet, due to its wide availability, low-cost and rapid interpretation, the ECG remains the most commonly used and, perhaps most important of available cardiovascular diagnostic tools; especially for rapid assessment of patients with symptoms compatible with acute coronary syndromes (ACS) and/or arrhythmia. The Electrocardiogram in Coronary AbstractThe electrocardiogram (ECG) remains the most commonly used and, perhaps most important of available cardiovascular diagnostic tools; especially for rapid assessment of patients with symptoms compatible with acute coronary syndromes (ACS) and/or arrhythmia. ST elevation is thought to represent transmural ischemia due to thrombotic occlusion of an epicardial artery. Emergent reperfusion therapy by primary percutaneous intervention (PCI) or thrombolytic therapy is usually indicated. In contrast, patients without ST segment elevation are treated conservatively in the initial stages. However, the distinction between ST elevation myocardial infarction (STEMI) and non ST elevation ACS (NSTE-ACS) is not always clear. Many patients with compatible symptoms have ST elevation not due to "transmural ischemia". On the other hand, occasionally, patients may have acute ischemia due to complete occlusion of an epicardial artery, but their ECG may show minor degree of ST elevation. Moreover, certain distinct ECG patterns have been described in patients presenting without ST elevation that are associated with higher risk. Recognition of these specifi c patterns of NSTE-ACS, as well as common patterns suggesting non-ischemic ST elevation is crucial.

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“…Electrocardiography is often nonspecific (eg, sinus tachycardia, nonspecific ST or T-wave changes). Occasionally, heart block (atrioventricular block or intraventricular conduction delay), ventricular arrhythmia, or injury patterns with ST-or T-wave changes mimicking myocardial ischemia or pericarditis (pseudoinfarction pattern) may indicate poorer prognosis [Gorgels 2007]. A chest X-ray can offer data about the size and shape of hart, as well as identification of fluid in or around the heart that might indicate heart failure [Round 2007].…”

Section: Non-invasive Techniquesmentioning

confidence: 99%

Myocarditis in HIV Positive Patients

Cambrea¹

2011

Myocarditis

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Electrocardiography

Cited by 12 publications

References 49 publications

The value of the ECG for decision-making at first medical contact in the patient with acute chest pain

The value of the ECG for decision-making at first medical contact in the patient with acute chest pain

The Electrocardiogram in Coronary Artery Disease

Myocarditis in HIV Positive Patients

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