Value of post-resuscitation electrocardiogram in the diagnosis of acute myocardial infarction in out-of-hospital cardiac arrest patients

Differentiating between comatose patients resuscitated from acute coronary syndrome-associated and subarachnoid hemorrhage-associated out-of-hospital cardiac arrest

“…In the present study, ACS was defined as unstable angina pectoris or acute myocardial infarction (AMI) caused by organic coronary artery disease [13]. All patients in the ACS-OHCA group were diagnosed by CAG as described in previous studies [6,7,13,19]. CAG findings were evaluated by board-certified interventional cardiologists.…”

“…Thrombotic occlusion and irregular eccentric coronary stenosis with a narrow neck, acute angles or craters, and thrombotic apposition were judged to represent acute culprit coronary lesions [6,7]. To avoid misdiagnosis of chronic occlusions as AMI, the occlusion had to be easily crossed by an angioplasty guide wire [19]. Definite non-cardiac endogenous comatose patients resuscitated from OHCA were divided into SAH patients (the SAH-OHCA group) and non-SAH patients.…”

Out-of-hospital cardiac arrest

“…According to Sideris et al, ECGs in 46% of OHCA patients in whom angiography did not confirm coronary disease (105 patients) showed signs of acute coronary syndrome (ST elevation 16%, ST depression 21%, and LBBB 9%) (ref. 24 ). This can be explained by the effects of temporary anoxia in the myocardium during the cardiac arrest, which often manifests as ischemic changes on ECGs recorded immediately after ROSC.…”

Impact of Percutaneous Coronary Intervention Performance Reporting on Cardiac Resuscitation Centers

“…In one recent series, 32% of patients with OHCA and sustained return of spontaneous circulation (ROSC) had ST-segment elevation on their first documented ECG. 1 The vast majority of patients are unable to give a history of prearrest symptoms on hospital arrival because they are comatose.…”