The Reliability of the Electrocardiogram in Myocardial Infarction

Woods, J.D.; Laurie, W.; Smith, W.G.

doi:10.1016/s0140-6736(63)90170-3

Cited by 73 publications

(8 citation statements)

References 10 publications

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“…Most authors agree that the ECG is rarely completely normal in myocardial infarction during the acute stage if serial registrations have been used (26, 28,30). Eisner and Schweizer, however, state that seven of their 164 patients had a completely normal ECG (there are no comments on the number and/or time of registration of the ECGs during the illness (5)).…”

Section: Discussionmentioning

confidence: 99%

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Atypical Case Histories and Electrocardiograms in Myocardial Infarctions

Erikssen

Müller

Anderssen

1970

Journal of Internal Medicine

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Abstract. The case histories and ECGs of 215 patients with a diagnosis of recent myocardial infarction have been examined with special reference to atypical findings. One hundred and seventy‐six had their first infarction, while 39 had had at least one myocardial infarction previously. Sixty‐eight per cent had typical and thirty‐two per cent atypical ECGs according to accepted criteria. The different non‐diagnostic ECG patterns are summarized, showing that 40% had ST‐T changes as the main change, 17% unchanged Q‐wave pattern from previously known myocardial infarctions, and 21% the R/S pattern of Perloff (19). It is suggested that patients with this R/S pattern (in the absence of pitfalls of Perloff) should be considered to have strictly posterior myocardial infarctions. The inclusion of these patients would increase the diagnostic score from 68% to 75% in the present study. No patient had a completely normal ECG. Discussion of some simple, general ECG principles shows that one can never expect to diagnose more than a certain number of recent myocardial infarctions in the ECG. The most common reasons for the ECG being non‐diagnostic of myocardial infarction are summarized. It is also stressed that Q‐wave patterns are not always diagnostic of myocardial infarctions, as they may also be seen in other, more rare forms of heart disease, probably most often in primary myocardial disease. Ten per cent had atypical case histories, and the different presenting symptoms are summarized. Thorough examination of patients with such symptoms with special reference to possible myocardial infarction as the underlying cause may disclose a certain number of recent myocardial infarctions which would otherwise have been overlooked.

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Section: Discussionmentioning

confidence: 99%

“…There still seems to be much controversy about the electrocardiographic criteria for a diagnosis of myocardial infarction. Autopsy studies (5, 12, 13, 23,26,30,31) seem to show that a considerable number of infarctions are overlooked in clinical practice.…”

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confidence: 99%

Atypical Case Histories and Electrocardiograms in Myocardial Infarctions

Erikssen

Müller

Anderssen

1970

Journal of Internal Medicine

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“…At autopsy of a fibrotic myocardium or an infarction less than six hours old, it is difficult to say exactly where the fresh infarction lay (27).…”

Section: Discussionmentioning

confidence: 99%

Influence of the Site of Myocardial Infarction on Mortality Rate

Isomäki

Takala

Räsänen

1969

Journal of Internal Medicine

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Abstract. The influence of the location of infarction, determined by electrocardiography, on mortality in a series of 864 patients with myocardial infarction has been studied restrospectively. 183 of these patients died (21.2%); 136 were autopsied and the location of the infarction was determined histologically. On the basis of the ECG findings the material was divided into anteroseptal, anterior, posterior and indefinite groups. Mortality in the indefinite group was 38.0%, anteroseptal group 23.8, anterior 22.8 and posterior 14.2%. In view of the autopsy results it would seem that the mortality rate for anteroseptal infarction is higher than that for anterior or posterior infarction. Diabetes and hypertension did not, in the present series, affect the infarction mortality, whereas bundle branch block seen in the ECG distinctly increased the mortality.

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“…This has been established by a number of studies correlating electrocardiograms recorded shortly before death with the state 531 of the heart at subsequent necropsy. For example, Woods, Laurie, and Smith (1963) analysed a necropsy series of 122 cases with ischaemic myocardial damage, all of whom had at least one adequate 12lead record; all cases with acute damage had a tracing taken within 48 hours of death. Of the 122 patients, 95 had major confluent infarction, and the remainder had patchy ischaemic fibrosis.…”

Section: David Short*mentioning

confidence: 99%

An electrocardiogram reporting service: its role and its risks.

Short¹

1969

Heart

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The Reliability of the Electrocardiogram in Myocardial Infarction

Cited by 73 publications

References 10 publications

Atypical Case Histories and Electrocardiograms in Myocardial Infarctions

Atypical Case Histories and Electrocardiograms in Myocardial Infarctions

Influence of the Site of Myocardial Infarction on Mortality Rate

An electrocardiogram reporting service: its role and its risks.

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