Prehospital Diagnosis of ST-segment Elevation Myocardial Infarction Using an “All-Posterior” 12-Lead Electrocardiogram

Russi, Christopher S.; Myers, Lucas A.; Kolb, Logan J.; Steever, Kevin; Nestler, David M.; Bjerke, Mary Christine; White, Roger D.; Ting, Henry H.

doi:10.3109/10903127.2011.561414

Cited by 6 publications

(6 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, the use of the 15-lead ECG confirms the posterior MI and is superior to the findings in the anterior leads (4). Besides, the incidence of isolated posterior MI is not defined and has been reported in studies ranging from 0% to 7-12% (18, 23).…”

Section: Discussionmentioning

confidence: 78%

“…The term “posterior infarction” identifies an AMI that insults the left ventricular wall by occlusion of the right coronary artery–posterior descending branch or the circumflex artery (15). It accounts for 15-21% of all AMI (4, 5, 6, 13), often in conjunction with inferior or lateral ones. The true posterior AMI is a rare entity, as it has been shown in our study.…”

Section: Discussionmentioning

confidence: 99%

“…Nonetheless, a diagnostic initial ECG in a patient with AMI will allow the physician to promptly start the appropriate therapy, mainly reperfusion. It has repeatedly been demonstrated that recording additional leads on initial ECG may improve its sensitivity and the prognosis of selected cases of ACS patients (4, 5). Moreover, additional lead ECGs may reveal more accurately the extend of the myocardial injury (6).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Importance of the 15-lead Versus 12-lead ECG Recordings in the Diagnosis and Treatment of Right Ventricle and Left Ventricle Posterior and Lateral Wall Acute Myocardial Infarctions

Vogiatzis¹,

Koulouris²,

Ioannidis³

et al. 2019

Acta Inform Med

View full text Add to dashboard Cite

Introduction: The 12-lead ECG at admission of patients suffering from acute myocardial infarction (AMI) is mandatory for accurate diagnosis and prompt therapeutic measures, mainly reperfusion. It has been shown that recording additional ECG leads may improve the diagnostic accuracy and therefore, the prognosis of selected cases. Aim: The aim of the study was to assess the usefulness of the 15-lead ECG (12 classic plus 3 posterior leads) in the management of chest pain patients, especially when 12-lead ECG is not diagnostic of AMI. Methods: Total amount of 186 consecutive patients (127 men, 59 women, mean age 69.7±13.8 years) were admitted with an acute coronary syndrome. The initial ECG recorded the 12 classic leads, and subsequently, the 3 additional posterior leads. Demographic and clinical data, including ECG alterations and selected treatment strategy, were also studied. The cumulative impact of the 15-lead ECG on the diagnosis and management of AMI were, overall, evaluated. Results: The 12-lead ECG was diagnostic of ST-elevation AMI (STEMI) in 158 patients (Group A–84.5%) who were promptly reperfused. On the other hand, the interpretation of the posterior leads was required in 28 patients (Group B–15.1%) to establish the STEMI diagnosis warranting reperfusion therapy. Multivariate analysis illustrated that the 15-lead ECG was the only factor associated with achieving the STEMI diagnosis in non-conclusive 12-lead ECG cases (OR=2.43–p=0.04). Conclusion: The use of the 15-lead ECG contributes to a faster and more accurate diagnosis of STEMI, particularly in the Emergency Department, facilitating the prompt reperfusion therapy.

show abstract

Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Importance of the 15-lead Versus 12-lead ECG Recordings in the Diagnosis and Treatment of Right Ventricle and Left Ventricle Posterior and Lateral Wall Acute Myocardial Infarctions

Vogiatzis¹,

Koulouris²,

Ioannidis³

et al. 2019

Acta Inform Med

View full text Add to dashboard Cite

show abstract

“…Three articles described paramedicine-initiated catheter lab activation [ 259 – 261 ]. One study focused on non-ST elevation MI [ 262 ], another on alternative lead placement [ 263 ], and another on the identification by paramedics of a rare presentation of an acute coronary syndrome [ 264 ]. Of the two articles in the Transport theme, one focused on transport time [ 265 ] and the other on ambulance diversion [ 266 ] as related to MI treatment.…”

Section: Resultsmentioning

confidence: 99%

Looking back to inform the future: a review of published paramedicine research

Cavanagh

Blanchard

Weiss

et al. 2023

BMC Health Serv Res

View full text Add to dashboard Cite

Objective Paramedicine has evolved in ways that may outpace the science informing these changes. Examining the scholarly pursuits of paramedicine may provide insights into the historical academic focus, which may inform future endeavors and evolution of paramedicine. The objective of this study was to explore the existing discourse in paramedicine research to reflect on the academic pursuits of this community. Methods We searched Medline, Embase, CINAHL, Google Scholar and Web of Science from January, 2006 to April, 2019. We further refined the yield using a ranking formula that prioritized journals most relevant to paramedicine, then sampled randomly in two-year clusters for full text review. We extracted literature type, study topic and context, then used elements of qualitative content, thematic, and discourse analysis to further describe the sample. Results The initial search yielded 99,124 citations, leaving 54,638 after removing duplicates and 7084 relevant articles from nine journals after ranking. Subsequently, 2058 articles were included for topic categorization, and 241 papers were included for full text analysis after random sampling. Overall, this literature reveals: 1) a relatively narrow topic focus, given the majority of research has concentrated on general operational activities and specific clinical conditions and interventions (e.g., resuscitation, airway management, etc.); 2) a limited methodological (and possibly philosophical) focus, given that most were observational studies (e.g., cohort, case control, and case series) or editorial/commentary; 3) a variety of observed trajectories of academic attention, indicating where the evolution of paramedicine is evident, areas where scope of practice is uncertain, and areas that aim to improve skills historically considered core to paramedic clinical practice. Conclusions Included articles suggest a relatively narrow topic focus, a limited methodological focus, and observed trajectories of academic attention indicating where research pursuits and priorities are shifting. We have highlighted that the academic focus may require an alignment with aspirational and direction setting documents aimed at developing paramedicine. This review may be a snapshot of scholarly activity that reflects a young medically directed profession and systems focusing on a few high acuity conditions, with aspirations of professional autonomy contributing to the health and social well-being of communities.

show abstract

“…However, severely ill patients placed in prolonged prone positioning to treat refractory hypoxemia secondary to acute respiratory distress syndrome often will have ECG leads placed on their back side instead, directly posterior to lead placement in the traditional supine position ( Figure 2). 4 This may affect the interpretation of the ECGs, especially when lead placement is not annotated.…”

Section: Discussionmentioning

confidence: 99%

Influence of Prone Positioning on Electrocardiogram in a Patient With COVID-19

2020

View full text Add to dashboard Cite

A woman in her 50s with morbid obesity and obstructive sleep apnea presented with 3 days of fever with a temperature up to 39 °C, anosmia, and shortness of breath. Physical examination findings were significant for oxygen saturation of 85% on room air and coarse rales at the lung bases bilaterally. Chest radiography was suggestive of bilateral multifocal pneumonia. Results of a nasopharyngeal swab for coronavirus disease 2019 (COVID-19) were positive by reverse transcriptase-polymerase chain reaction. She was admitted to the intensive care unit for management.Upon admission, the patient began hydroxychloroquine and azithromycin combination therapy. On hospitalization day 2, the patient developed acute respiratory distress syndrome (ARDS) requiring intubation and mechanical ventilation. Management strategies for refractory hypoxia were not successful until she was placed in a prone position. She was maintained in a prone position for 16 hours followed by supine positioning as tolerated for 4 hours a day. Given the treatment with hydroxychloroquine and azithromycin, serial electrocardiograms (ECGs) were performed to monitor QT interval dur-

show abstract

Prehospital Diagnosis of ST-segment Elevation Myocardial Infarction Using an “All-Posterior” 12-Lead Electrocardiogram

Cited by 6 publications

References 1 publication

The Importance of the 15-lead Versus 12-lead ECG Recordings in the Diagnosis and Treatment of Right Ventricle and Left Ventricle Posterior and Lateral Wall Acute Myocardial Infarctions

The Importance of the 15-lead Versus 12-lead ECG Recordings in the Diagnosis and Treatment of Right Ventricle and Left Ventricle Posterior and Lateral Wall Acute Myocardial Infarctions

Looking back to inform the future: a review of published paramedicine research

Influence of Prone Positioning on Electrocardiogram in a Patient With COVID-19

Contact Info

Product

Resources

About