ST-segment variations after acute myocardial infarction. Relationship to clinical status.

Abstract

SUMMARY The degree of vectorcardiographic ST-sgment elevation was employed as an index of myocardial ischemic injury in a study of 27 patients after acute myocardial infarction (AMI). The ST-segment vector magnitude (STVM) (STVM).9 This has allowed for multiple, serial, rapid determinations of STVM, and our previous studies have shown a good correlation between STVM and ZST obtained from 35 lead precordial maps (N = 51, r = 0.818). 10 We employed this VCG system in a study of patients with AMI in whom we followed serial changes in STVM to characterize what ST-segment alterations were associated with infarct resolution and extension as well as with death after AMI. Normal values for STVM were determined and changes due to pericarditis were examined.

Myocardial infarct extension: incidence and relationship to survival.

“…All four patients had an arteriovenous oxygen difference . 6 vol%. Pulmonary capillary wedge pressure and arteriovenous oxygen difference were not available in the four patients with myocardial infarct extension who survived.…”

Electrocardiographic mapping of ischaemic myocardial insult

“…The ST-segment elevation decreases slowly to normal values in uncomplicated myocardial infarction, but can remain elevated long after myocardial enzyme release has ended (34). ST-segment elevation remains high in patients with extensive transmural myocardial infarction and congestive heart failure, and major increase in the ST-segment strongly suggests a fatal outcome or reinfarction (35). Although the determina-tion of precordial ST-segment elevation has appeared useful for determining infarct extention (35, 36), its usefulness for detecting the influence of drugs on rhe ischaemic injury is debatable.…”