scholarly journals Characteristics and mechanism of reciprocal ST-segment depression in acute ST segment elevation myocardial infarction

2021 ◽  
Author(s):  
Qijun Gao ◽  
fang fang bie ◽  
yingfu hu ◽  
bo yang ◽  
yafeng chen
Keyword(s):  
Myocardial Infarction ◽  
Action Potential ◽  
Negative Electrode ◽  
Positive Electrode ◽  
Inferior Myocardial Infarction ◽  
Anterior Myocardial Infarction ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Infarct Area ◽  
St Segment

Background:At present, the mechanism of reciprocal ST-segment depression(RSTD) is still not clear. Purpose : We proposed the mechanism of RSTD: the action potential of negative electrode of the lead was weakened or disappeared, and the AP of positive electrode could not be completely offset. The electrocardiograms of patients with acute STEMI were analyzed to explore the mechanism of RSTD. Methods: The electrocardiogram and angiography of 85 STEMI patients were retrospectively analyzed to summarize the characteristics of ST segment changes. Results: A total of 85 patients were included, of which 75 were patients with RSTD (10 patients with anterior myocardial infarction had no RSTD), all 45 patients with inferior myocardial infarction had limb leads RSTD, and 37 of them had anterior lead ST segment depression.Thirty patients with anterior myocardial infarction were accompanied by mild ST segment changes in the limb leads. According to the characteristics of RSTD, it is speculated that the mechanism of RSTD is that the action potential of infarct area decreased , which could not offset the action potential in non-infarct area. By using this mechanism, all ST segment changes in STEMI can be explained by the proposed mechanism, and the value of the ST segment changes can be calculated in limb leads. Conclusion: the mechanism of RSTD in acute myocardial infarction is that the negative electrode action potential of the lead was weakened or disappeared, and the positive electrode action potential could not be completely offset, resulting in ST segment depression.

scholarly journals Characteristics and mechanism of reciprocal ST-segment depression in acute ST segment elevation myocardial infarction

2022 ◽  
Author(s):  
Qijun Gao ◽  
Fangfang Bie ◽  
Yinfu Hu ◽  
Yafeng Chen ◽  
Bo Yang
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Action Potential ◽  
Negative Electrode ◽  
Inferior Myocardial Infarction ◽  
Anterior Myocardial Infarction ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Infarct Area ◽  
St Segment

Abstract Background: At present, the mechanism of reciprocal ST-segment depression(RSTD) is still not clear.Methods: The electrocardiogram and angiography of 85 STEMI patients were retrospectively analyzed to summarize the characteristics of ST segment changes and explore the mechanism of RSTD.Results: A total of 85 patients were included, of which 75 were patients with RSTD (10 patients with anterior myocardial infarction had no RSTD), all 45 patients with inferior myocardial infarction had limb leads RSTD, and 37 of them had anterior lead ST segment depression.Thirty patients with anterior myocardial infarction were accompanied by mild ST segment changes in the limb leads. According to the characteristics of RSTD, it is speculated that the mechanism of RSTD is that the action potential of infarct area decreased , which could not offset the action potential in non-infarct area.Conclusion: the mechanism of RSTD in acute myocardial infarction maybe that the negative electrode action potential of the lead was weakened or disappeared, and the positive electrode action potential could not be completely offset, resulting in ST segment depression.

scholarly journals Comparison of ST segment Changes in Lead aVR with in-Hospital Outcomes in Patients with First attack of Acute Inferior ST Segment Elevation Myocardial Infarction

2019 ◽  
Vol 11 (2) ◽  
pp. 123-128
Author(s):  
Mohammad Jalal Uddin ◽  
M Saiful Bari ◽  
MA Bari ◽  
Mirza Md Nazrul Islam ◽  
M Abdullah Al Safi Majumder ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Inferior Myocardial Infarction ◽  
Hospital Outcomes ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Group A ◽  
Lead Avr ◽  
Group B ◽  
Acute Inferior Myocardial Infarction

Background: Inferior wall ST segment elevation myocardial infarction is considered to be at lower risk than anterior wall STEMI except in some cases. The aim of our study was to evaluate the relationships between on admission ST segment changes in lead aVR and short term in-hospital outcomes in acute isolated inferior myocardial infarction undergoing thrombolysis. Methods: Total 107 of first attack of inferior STEMI patients were included and all were thrombolysed by streptokinase. The sample population were divided into three groups based on the condition of ST segment in lead aVR on admission and in hospital outcomes were observed: Group –A: ST segment elevation ≥0.5 mm; Group –B: ST segment depression ≥0.5 mm; Group-C: Iso-electric ST segment. Results: 6.54% of study population had ST segment elevation in lead aVR, 53.27% had ST segment depression in lead aVR and 41.12% had isoelectric ST segment in lead aVR. During hospital stay mortality rates of patients of Group A, Group B and Group C were 33.3%, 5.3% and 4.5 % respectively; rates of cardiogenic shock were 33.3%, 8.8% and 2.3% respectively; heart failure rates were 50.0%, 15.8% and 4.5% respectively; rates of recurrent angina after thrombolysis were 66.7%, 33.3% and 6.8% respectively in three groups and the mean LVEF were 40.17, 48.61 and 52.50 respectively. Conclusion: The on admission-isoelectric ST segment in lead aVR in acute inferior myocardial infarction predicted better in-hospital outcomes in comparison to ST segment elevation and ST segment depression in aVR. On the other hand, ST segment elevation in lead aVR predicted worse in-hospital outcomes than ST segment depression in acute inferior myocardial infarction in spite of reperfusion by thrombolytic. Cardiovasc. j. 2019; 11(2): 123-128

First-degree atrioventricular block in acute anterior myocardial infarction

2020 ◽  
pp. 021849232097148
Author(s):  
Arvin Zabeh ◽  
Masoumeh Jahanafrouz ◽  
Babak Kazemi ◽  
Leili Pourafkari ◽  
Ghiti Davarmoin ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Hospital Mortality ◽  
Atrioventricular Block ◽  
Left Ventricular ◽  
Hospital Death ◽  
Anterior Myocardial Infarction ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Pr Interval

Background There is paucity of data regarding the prognostic implications of first-degree atrioventricular block in patients with acute anterior myocardial infarction as a distinct group. The aim of this study was to elucidate the association of prolonged PR interval with hospital clinical outcomes in patients with treated with thrombolysis. Methods Three hundred consecutive patients with a first acute anterior ST-segment elevation myocardial infarction undergoing thrombolysis between October 2017 and March 2018, were retrospectively enrolled in this study. They were divided into two groups based on PR interval on admission: PR interval ≤200 ms, and PR interval > 200 ms. Hospital mortality and complications were compared between the 2 groups. Results Of the 300 patients, 26 (8.66%) had first-degree atrioventricular block on initial presentation. Overall, hospital death occurred in 20 (6.66%) patients. Patients with PR interval > 200 ms had a higher hospital mortality rate (26.9%) than those without (4.7%, p < 0.001). In multivariate Cox regression analysis, only left ventricular systolic function and PR interval were independent predictors of hospital mortality (odds ratio = 1.031; 95% confidence interval: 1.008–1.056, p = 0.009 for PR interval). Conclusion In patients with a first acute anterior ST-segment elevation myocardial infarction treated with thrombolysis, first-degree atrioventricular block was associated with increased hospital mortality and a worse prognosis.

scholarly journals Anterior Myocardial Infarction Associated with Myocardial Bridging in a Young Man

2020 ◽  
Vol 9 (2) ◽  
Author(s):  
Ngow HA ◽  
Wan Khairina WMN
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Medical Literature ◽  
Case Reports ◽  
Coronary Angiogram ◽  
Myocardial Bridging ◽  
Anterior Myocardial Infarction ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

A 43-year-old man presented with acute extensive anterior ST-segment elevation myocardial infarction. During coronary angiogram, a segment of myocardial bridging was noted in the mid-segment of left anterior descending artery. The association of myocardial bridging and an anterior ST segment elevation is rarely reported in the medical literature. Myocardial bridging is caused by systolic compression of a coronary artery by overlying myocardium tissue. It is a rare coronary artery anomaly, which usually has a benign prognosis despite some case reports of myocardial ischemia leading to myocardial infarction, lethal arrhythmias and sudden cardiac death. We report one such case of myocardial bridging that was complicated with acute extensive anterior myocardial infarction.

scholarly journals Association of Increased Tpeak-to-end/QT ratio with Malignant Ventricular Arrhythmias in Acute Anterior ST-Segment Elevation Myocardial Infarction

2017 ◽  
Vol 32 (1) ◽  
pp. 10-17
Author(s):  
Abeeda Tasnim Reza ◽  
Md Mamunur Rashid ◽  
Md Mohsin Hossain ◽  
Khondoker Shaheed Hussain ◽  
Md Tanvir Rahman ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Ventricular Arrhythmias ◽  
Close Monitoring ◽  
Roc Curve Analysis ◽  
Anterior Myocardial Infarction ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Group I ◽  
St Segment ◽  
Surface Ecg

Background: Increased Tpeak-to-end/QT ratio on 12 lead surface electrocardiogram (ECG) has been shown to be the predictor of arrhythmogenesis in various cardiac disorders. There is limited data regarding association of these two parameters with malignant ventricular arrhythmias (MVA) in acute ST-segment elevation myocardial infarction (STEMI) patients. Objectives: This study was conducted to evaluate association of increased Tpeak-to-end/QT ratio with MVAs in acute anterior STEMI. Methods: 178 patients with acute anterior STEMI admitted within 12 hours of onset of chest pain into the Coronary Care Unit, Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, were enrolled from November 2015 to October 2016. Tpeak-to-end/QT ratio was calculated from surface ECG at the time of admission. The patients were divided into two groups, group I and II according to normal (?0.25) and increased Tpeak-to-end/QT ratio (>0.25). Each group was monitored for development of MVAs for the first 48 hours of myocardial infarction. Results: MVAs were significantly higher in group II than group I (19.5% vs 3.1%, p<0.001). Multivariate regression analysis showed significant association (p=0.002) of increased Tpeak-to-end/QT ratio with MVAs (Odds Ratio, 3.845).Receiver operating characteristic (ROC) curve analysis showed that Tpeak-to-end/QT ratio <0.25 had a negative predictive value of 96.88% for the prediction of MVAs. Conclusion: The study demonstrated that there was significant association of increased Tpeak-to-end/QT ratio with malignant ventricular arrhythmias in acute anterior STEMI patients. Thus analysis of 12 lead surface ECG on admission may help predict malignant ventricular arrhythmias in the first 48 hours of acute anterior myocardial infarction and close monitoring with prompt management may be ensured in high risk patients.Bangladesh Heart Journal 2017; 32(1) : 10-17

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