دورية أكاديمية
Acute diagonal-induced ST-elevation myocardial infarction and electrocardiogram-guidance in the era of primary coronary intervention: New insights into an old tool
| العنوان: | Acute diagonal-induced ST-elevation myocardial infarction and electrocardiogram-guidance in the era of primary coronary intervention: New insights into an old tool |
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| المؤلفون: | Abu Fanne, Rami, Kleiner Shochat, Michael, Shotan, Avraham, Frimerman, Aharon, Maraga, Emad, Amsalem, Naama, Levi, Yaniv, Meisel, Simcha R |
| المصدر: | European Heart Journal. Acute Cardiovascular Care ; volume 9, issue 8, page 827-835 ; ISSN 2048-8734 2048-8726 |
| بيانات النشر: | Oxford University Press (OUP) |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Cardiology and Cardiovascular Medicine, Critical Care and Intensive Care Medicine, General Medicine |
| الوصف: | Background: Previous studies, published before the advent of primary reperfusion, described the electrocardiographic features of ST-segment elevation myocardial infarction (STEMI) caused by total diagonal artery occlusion, as demonstrated at pre-discharge coronary angiography. We aimed to assess the electrocardiographic and echocardiographic features in STEMI unequivocally attributed to a diagonal lesion in the era of primary coronary intervention. Methods: The electrocardiograms and echocardiograms of patients sustaining STEMI caused by diagonal artery involvement were compared with those of patients with STEMI attributed to proximal or mid left anterior descending artery (LAD) lesions. ST-segment deviations were measured at four different points in each lead and analyzed against TIMI flow and SNuH score. The electrocardiographic and echocardiographic features of each group were mapped. Results: In contrast to previous studies claiming an ever-present incidence of at least 1-mm ST-segment elevation in leads I and aVL with diagonal STEMI, we report 86% of any ST-elevation in leads I, aVL and V2 (64–71% for ST-elevation >1 mm). Both higher SNuH score and pre-intervention TIMI flow were associated with larger lateral ST-elevations (85.7% and 86.4–95.5%, respectively). Higher prevalence of ST-depression in the inferior leads reflecting reciprocal changes was observed in patients with diagonal-induced STEMI (57–76% vs. 24–51% in LAD obstructions, p <0.05). Conclusion: The most sensitive and predictive sign for acute ischemia was any degree of ST-deviation measured 1 mm beyond the J point. ST-elevations in I, aVL and V2, sparing V3-V5, strongly favor isolated diagonal lesion. Proximal LAD lesion lacking ST-segment elevations in leads I and aVL is primarily due to wraparound LAD anatomy. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1177/2048872619828291 |
| الإتاحة: | https://doi.org/10.1177/2048872619828291Test http://academic.oup.com/ehjacc/article-pdf/9/8/827/36165931/ehjacc0827.pdfTest |
| حقوق: | https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_modelTest ; http://journals.sagepub.com/page/policies/text-and-data-mining-licenseTest |
| رقم الانضمام: | edsbas.AEA8B610 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1177/2048872619828291 |
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