Takotsubo syndrome vs anterior STEMI electrocardiography; a meta-analysis and systematic review

ECG differences and ECG predictors in patients presenting with ST segment elevation due to myocardial infarction versus takotsubo syndrome

“…Therefore, our study could provide a more clinically representative picture of the typical admission ECG pattern in STE-TS in relation to STEMI. Additionally, with respect to the exact localization and distribution of ST depressions, our findings are an important extension of the previous knowledge that the absence of reciprocal ST depression per se suggests STE-TS over STEMI [7] , [17] , [23] , [25] , [27] .…”

“…In both conditions, T wave inversion develops whereas QT interval prolongation is more typical for the temporal ECG development in TS [3] , [6] . Several methods, based on a variety of ECG changes, have been suggested to distinguish TS from STEMI [6] , [7] . TS presenting with ST elevation (STE-TS) is especially challenging in the differential diagnosis against STEMI and none of the proposed methods can distinguish TS from STEMI reliably enough to avoid coronary angiography.…”

Temporal electrocardiographic changes in anterior ST elevation myocardial infarction versus the Takotsubo syndrome

“…Several electrocardiographic (ECG) criteria has been proposed to distinguish between acute myocardial infarction (AMI) and TTS, none of which can reliably differentiate the two conditions to avoid coronary angiography to exclude coronary occlusion. [1] , [2] , [3] , [4] , [5] .…”

“…According to previous literature, the most common ECG changes on admission in TTS are ST elevation and T wave inversion; and the most common ECG changes in the sub-acute phase are T wave inversion and QT prolongation. Conversely, ST depression (in particular reciprocal ST depression) and pathological Q waves on admission are less common [3] , [5] . Although T wave inversion has been regarded as a hallmark ECG change in TTS [2] , [6] , [7] , [8] , it is not included in the majority of ECG criteria used to differentiate TTS from STEMI on admission.…”