Optimizing the initial 12-lead electrocardiographic diagnosis of acute myocardial infarction

Abstract

Different definitions of 'significant' ST elevation led to marked variations in sensitivity and specificity for diagnosis of acute myocardial infarction. Multiple QRST features in addition to ST elevation only marginally improved overall classification.

Vectorcardiographic ST deviations related to increased heart rate in the absence of ischemia in an experimental pig model

“…Arterial Po 2 (kPa) Cao 2 Arterial oxygen content (mL/L) gcvHb Great cardiac venous hemoglobin (g/L) gcvHbo 2 Great cardiac venous saturation (%) Pgcvo 2 Great cardiac venous Po 2 (kPa) Cgcvo 2 Great cardiac venous oxygen content (mL/L) Q gcv Great cardiac venous flow (mL/min) MVo 2 Myocardial oxygen consumption (mL/min) ST-VM, STC-VA, and STC-VM values were grouped for absolute HRs (mean F SEM). Analyses were performed to detect changes in all parameters grouped for HR during the pacing protocol using repeated measurements analysis of variance test.…”

“…Electrocardiography (ECG), in particular, ST-segment assessment, is the fundamental method to detect myocardial ischemia and coronary artery disease [1,2]. Vectorcardiography is one electrocardiographic method that can be used in diagnostic situations to detect myocardial ischemia and infarction.…”

ECG in Acute Myocardial Infarction in the Reperfusion Era

“…The best criteria to classify abnormally elevated ST-segment are resumed in the Minnesota code 9-2 and are defined as ST-segment elevation of 1 mm in at least 1 peripheral lead, or 2 mm elevation in at least 1 precordial lead. These criteria have 94% of specificity for STEMI with a sensitivity of 56% in STEMI diagnosis (Menown et al, 2000). The threshold values results from recognition that some elevation of the junction of the QRS complex and the ST-segment (J-point) is a normal finding.…”

Thoughts About the Abnormalities in the Electrocardiogram of Patients with Acute Myocardial Infarction with Emphasis on a more Accurate Method of Interpreting ST‐segment Displacement: Part I

“…5 For example, a septal infarct may produce an abnormal Q wave that is 0.02 s or less in duration. After all, the septum is normally depolarized in less than 0.02 s-a septal infarct cannot produce a Q wave that is 0.04 s in duration.…”