Prognostic value of an electrocardiographic sign in acute myocardial infarction

Cardiac rupture complicating myocardial infarction

“…Signs of impending or ongoing myocardial rupture, however, are less well defined. Several ECG abnormalities have been associated with rupture of the left ventricular wall, including evidence of transmural MI (Q wave development) [4] or infarct expansion (recurrent ST elevation or depression, and pseudo-normalization of inverted T waves) [7,16], persistent ST segment elevation [4,65,72,73], new Q waves in two or more leads [61], and pseudo-normalization of pathological T wave inversion in the precordial leads [73]. However, none of these ECG signs are sensitive and specific enough to identify patients with an impending or ongoing rupture.…”

Left ventricular free wall rupture: clinical presentation and management

“…2 14 In-hospital free wall rupture is often preceded by chest pain similar to that of acute myocardial infarction1 2 5 15 16 20 23 26; this may be associated with re-elevation of the ST segment or with flat or negative T waves becoming positive 213 27 …”

Bedside evaluation in cardiac emergencies

“…and an M complex (a monophasic RS complex with an upright T wave and progressive ST-segment elevation) was reported in one series. 15 Electromechanical dissociation is a common terminal rhythm.…”