ELECTROCARDIOGRAPHIC SIGNS OF ACUTE MYOCARDIAL ISCHEMIA AS EQUIVALENTS OF ST ELEVATION MYOCARDIAL INFARCTION
https://doi.org/10.21886/2712-8156-2020-1-1-43-49
Abstract
Early initiation of reperfusion therapy remains to be crucial step of management for ST elevation myocardial infarction (STEMI), as elevation on a 12-lead electrocardiogram (ECG) is considered as a result of coronary occlusion or critical stenosis. At the same time, nearly 10 – 25 % of non-STEMI patients, according to coronary angiography, do have occlusion or critical stenosis of major epicardial vessel. Reperfusion delays in this case lead to worse outcomes. Although criteria for STEMI equivalents briefly mentioned in the current recommendations, data on those specific ECG patterns are lacking. By searching MEDLINE and EMBASE was conducted a structured review of non-STEMI patterns, connected with critical stenosis or occlusion, the sensitivity and specificity data was also provided. It is hard to overestimate the clinical significance of revealing high risk patients in the absence of classical STEMI in the emergency department or the pre-hospital setting.
About the Authors
O. P. Ishevskaia
Kuban State Medical University
Russian Federation
Krasnodar
Russian Federation
Krasnodar
A. M. Namitokov
Research Institute — S.V. Ochapovsky Regional Clinical Hospital № 1
Russian Federation
Russian Federation
Cand. Sci. (Med.)
Krasnodar
E. D. Kosmacheva
Kuban State Medical University
Russian Federation
Russian Federation
Dr. Sci. (Med.)
Krasnodar
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64. Meyers H.P., Limkakeng Jr A.T., Jaffa E.J., Patel A., Theiling B.J., Rezaie S.R. Validation of the modified Sgarbossa criteria for acute coronary occlusion in the setting of left bundle branch block: A retrospective case-control study. American heart journal. 2015;170(6):1255-1264. DOI: 10.1016/j.ahj.2015.09.005.
65. Bertel N., Witassek F., Puhan M., Erne P., Rickli H., Naegeli B. Management and outcome of patients with acute myocardial infarction presenting with pacemaker rhythm. International journal of cardiology. 2017;230:604-609. DOI: 10.1016/j.ijcard.2016.12.047.
66. Mitchell G.J., Dodd K., Zvosec D.L., Chen E., Hart M. A., Marshall J. P103: Performance characteristics of the modified Sgarbossa criteria for diagnosis of acute
67. coronary occlusion in emergency department patients with ventricular paced rhythm and symptoms of acute coronary syndrome. Canadian Journal of Emergency Medicine. 2018;20(S1):S93-S93. DOI: 10.1017/cem.2018.301.
68. Chatterjee K., Harris A., Davies G., Leatham A. Electrocardiographic changes subsequent to artificial ventricular depolarization. British heart journal. 1969;31(6):770. DOI: 10.1136/hrt.31.6.770.
69. Wang J., Luo H., Kong C., Dong S., Li J., Yu H. Prognostic value of new-onset right bundle-branch block in acute myocardial infarction patients: a systematic review and meta-analysis. PeerJ. 2018;6:e4497. DOI: 10.7717/peerj.4497.
70. Widimsky P., Roháč F., Štásek J., Kala P., Rokyta R., Kuzmanov B. Primary angioplasty in acute myocardial infarction with right bundle branch block: should new onset right bundle branch block be added to future guidelines as an indication for reperfusion therapy? European heart journal. 2012;33(1):86-95.DOI: 10.1093/eurheartj/ehr291.
71. Strauss D.G., Loring Z., Selvester R.H., Gerstenblith G., Tomaselli G., Weiss R.G. Right, but not left, bundle branch block is associated with large anteroseptal scar. Journal of the American College of Cardiology. 2013;62(11):959-967. DOI: 10.1016/j.jacc.2013.04.060.
72. Neumann J.T., Sörensen N.A., Rübsamen N., Ojeda F., Schäfer S., Keller T. Right bundle branch block in patients with suspected myocardial infarction. European Heart Journal: Acute Cardiovascular Care. 2019;8(2):161-166. DOI: 10.1177/2048872618809700.
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Ishevskaia O.P., Namitokov A.M., Kosmacheva E.D. ELECTROCARDIOGRAPHIC SIGNS OF ACUTE MYOCARDIAL ISCHEMIA AS EQUIVALENTS OF ST ELEVATION MYOCARDIAL INFARCTION. South Russian Journal of Therapeutic Practice. 2020;1(1):43-49. (In Russ.) https://doi.org/10.21886/2712-8156-2020-1-1-43-49
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