Difficult ECGs in STEMI: lessons learned from serial sampling of pre- and in-hospital ECGs.

Ayer, Antoine; Terkelsen, Christian Juhl (2014). Difficult ECGs in STEMI: lessons learned from serial sampling of pre- and in-hospital ECGs. Journal of electrocardiology, 47(4), pp. 448-458. Elsevier 10.1016/j.jelectrocard.2014.03.010

[img] Text
1-s2.0-S0022073614001216-main-1.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (2MB)

Prehospital interpretation of electrocardiograms (ECGs) is crucial to ensure early diagnosis and optimal treatment of patients with ST elevation myocardial infarction (STEMI). Recognition of ST-segment elevations (STE) by qualified personnel in the prehospital phase has successfully reduced the delay from the first medical contact to reperfusion. A few other ECG patterns without true STE, referred to as "STEMI equivalents", bear the same prognostic significance, reflect imminent or ongoing transmural ischemia, but are less easily identified. Hyperacute T waves, de Winter ST-T complex, Wellens' syndrome, and posterior STEMI, as well as myocardial infarction in the presence of left bundle branch block, paced rhythm or left ventricular hypertrophy, among others are diagnostic challenges. This article reviews some critical examples of ischemic ECG patterns that may be ephemeral, misinterpreted by medical staff or not identified by automated ECG algorithms, and it emphasizes the importance of serial ECG acquisition.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Ayer, Antoine

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1532-8430

Publisher:

Elsevier

Language:

English

Submitter:

Antoine Ayer

Date Deposited:

24 Apr 2017 17:43

Last Modified:

05 Dec 2022 15:00

Publisher DOI:

10.1016/j.jelectrocard.2014.03.010

PubMed ID:

24792903

Uncontrolled Keywords:

Electrocardiogram; In-hospital ECG; Prehospital ECG; STEMI; STEMI equivalent; serial ECGs

BORIS DOI:

10.7892/boris.90965

URI:

https://boris.unibe.ch/id/eprint/90965

Actions (login required)

Edit item Edit item
Provide Feedback