Comparison of high-frequency QRS components and ST-segment elevation to detect and quantify acute myocardial ischemia

AbstractPrinzmetal’s angina, also known as Prinzmetal’s variant or Prinzmetal’s vasospastic angina is characterized by angina attacks caused by spasm of the great epicardial coronary arteries. Coronary artery endothelial dysfunction plays a crucial role in the development of this vasospastic angina. The attacks of vasospastic angina can be prevented with calcium antagonists and nitrates, whereas in refractory variant angina, coronary angioplasty with stenting may help prevent further coronary spasm. In this case report, we present a 52-year-old male patient with a transient electrocardiographic recording of acute myocardial ischemia with ST-segment elevation of the diaphragmal location accompanied by a total atrioventricular block immediately after exercise testing and as a first manifestation of Prinzmetal’s angina. After regression of the symptoms and electrocardiographic changes, significant pathomorphologic changes of coronary arteries were excluded by coronary angiography. Following discharge, the patient was treated with calcium antagonists and did not show symptoms during a 4-year follow-up period.

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Electrocardiographic scores of severity and acuteness of myocardial ischemia predict myocardial salvage in patients with anterior ST-segment elevation myocardial infarction

Journal of Electrocardiology ◽

10.1016/j.jelectrocard.2017.11.002 ◽

2018 ◽

Vol 51 (2) ◽

pp. 195-202 ◽

Cited By ~ 1

Author(s):

Yama Fakhri ◽

Maria Sejersten ◽

Mikkel Malby Schoos ◽

Henrik Steen Hansen ◽

Jean-Luc Dubois-Rande ◽

...

Keyword(s):

Myocardial Infarction ◽

Myocardial Ischemia ◽

Myocardial Salvage ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

St Segment

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Dobutamine-Induced Myocardial Ischemia and ST-Segment Elevation in Collateral-Dependent Myocardium

The American Journal of Cardiology ◽

10.1016/j.amjcard.2013.05.072 ◽

2013 ◽

Vol 112 (9) ◽

pp. 1293-1297 ◽

Cited By ~ 2

Author(s):

Jamshid Shirani ◽

Shruthi Pranesh ◽

Kimia Menhaji ◽

Vlad Cotarlan ◽

Alessandra Brofferio

Keyword(s):

Myocardial Ischemia ◽

St Segment Elevation ◽

St Segment

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Celebrating the 100th Birthday of the Electrocardiogram: Lessons Learned From Research in Cardiac Monitoring

American Journal of Critical Care ◽

10.4037/ajcc2002.11.4.378 ◽

2002 ◽

Vol 11 (4) ◽

pp. 378-386 ◽

Cited By ~ 14

Author(s):

Barbara J. Drew

Keyword(s):

Critical Care ◽

Myocardial Ischemia ◽

Current Trend ◽

Torsade De Pointes ◽

Acute Myocardial Ischemia ◽

Lessons Learned ◽

Cardiac Monitoring ◽

Acute Ischemia ◽

Antiarrhythmic Agents ◽

St Segment

The electrocardiogram continues to be the gold standard for the diagnosis of cardiac arrhythmias and acute myocardial ischemia. The treatment of arrhythmias in critical care units has become less aggressive during the past decade because research indicates that antiarrhythmic agents can be proarrhythmic, causing malignant ventricular arrhythmias such as torsade de pointes. However, during the same period, the treatment of acute myocardial ischemia has become more aggressive, with the goal of preventing or interrupting myocardial infarction by using new antithrombotic and antiplatelet agents and percutaneous coronary interventions. For this reason, critical care nurses should learn how to use ST-segment monitoring to detect acute ischemia, which is often asymptomatic, in patients with acute coronary syndromes. Because the electrocardiographic lead must be facing the localized ischemic zone of the heart to depict the telltale signs of ST-segment deviation, the challenge is to find ways to monitor patients continuously for ischemia without using an excessive number of electrodes and lead wires. The current trend is to use reduced lead set configurations in which 5 or 6 electrodes, placed at convenient places on the chest, are used to construct a full 12-lead electrocardiogram. Nurse scientists at the University of California, San Francisco, School of Nursing are at the forefront in developing and assessing the diagnostic accuracy of these reduced lead set electrocardiograms.

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