188: Prevalence of ST-Segment Elevation MyocardialInfarction In Patients With J-Point Notching on Initial Emergency Department Electrocardiograms

Turnipseed, Samuel D.; Lang, Kendrick J.; Laurin, Erik G.; Diercks, Deborah

doi:10.1016/j.annemergmed.2010.06.235

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“…Moreover, the 3-variable ECG criterion performed far better than any of the many published STE criteria, none of which had any important diagnostic utility (see Table 1). In an abstract published by Turnipseed, of over 1,000 consecutive patients with chest pain, there were only two anterior STEMI (no denominator given) that had at least two leads with a J-wave notch of at least 0.5 mm [30] In our study, although 14 % of STEMI (vs. 32 % of early repolarization) had at least one lead with a 0.5 mm J-wave notch, only 5 of 143 had two such leads vs. 9 of 171 in early repolarization (unpublished data). Thus, presence or absence of J-wave notching did not add to our overall rule.…”

Section: Differentiation Of Anterior Normal Variant St Elevation Frommentioning

confidence: 99%

Updates on the Electrocardiogram in Acute Coronary Syndromes

Smith

2012

Curr Emerg Hosp Med Rep

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The electrocardiogram (ECG) is the initial test in patients with suspected ACS. The ECG is the defining element of ST-segment elevation myocardial infarction (STEMI). Its most important use is in the detection of acute coronary obstruction, and it is the most important, cost-effective, and immediately available initial test in the decision for emergency reperfusion therapy. There is a recent interest in refining the sensitivity and specificity of the ECG for coronary occlusion, and thus for identifying subtle STEMI, as well as in recognizing pseudoinfarction patterns and thus avoiding false positive cath lab activations. Studies assessing the accuracy of cath lab activation, the differentiation of precordial ST-segment elevation due to normal variant from that of anterior STEMI, the diagnosis of STEMI in the presence of left bundle branch block, the differentiation of benign inferior ST-segment elevation from that of inferior STEMI, and the importance of ST-segment elevation in lead aVR will be discussed.

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Section: Differentiation Of Anterior Normal Variant St Elevation Frommentioning

confidence: 99%

Updates on the Electrocardiogram in Acute Coronary Syndromes

Smith

2012

Curr Emerg Hosp Med Rep

View full text Add to dashboard Cite

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188: Prevalence of ST-Segment Elevation MyocardialInfarction In Patients With J-Point Notching on Initial Emergency Department Electrocardiograms

Cited by 1 publication

References 0 publications

Updates on the Electrocardiogram in Acute Coronary Syndromes

Updates on the Electrocardiogram in Acute Coronary Syndromes

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