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Electrocardiographi...
Electrocardiographic changes in the differentiation of ischemic and non-ischemic ST elevation
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- Lindow, Thomas (författare)
- Lund University,Lunds universitet,Klinisk fysiologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Clinical Physiology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital,Region Kronoberg,Växjö Central Hospital
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- Pahlm, Olle (författare)
- Region Kronoberg
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- Khoshnood, Ardavan (författare)
- Lund University,Lunds universitet,Akutsjukvård,Forskargrupper vid Lunds universitet,Emergency medicine,Lund University Research Groups,Skåne University Hospital
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- Nyman, Ingvar (författare)
- Växjö Central Hospital
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- Manna, Daniel (författare)
- Växjö Central Hospital
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- Engblom, Henrik (författare)
- Region Kronoberg
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- Lassen, Annmarie Touborg (författare)
- Odense University Hospital
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- Ekelund, Ulf (författare)
- Lund University,Lunds universitet,Akutsjukvård,Forskargrupper vid Lunds universitet,Emergency medicine,Lund University Research Groups,Skåne University Hospital
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(creator_code:org_t)
- 2019-12-30
- 2020
- Engelska 8 s.
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Ingår i: Scandinavian cardiovascular journal : SCJ. - : Informa UK Limited. - 1651-2006 .- 1401-7431. ; 54:2, s. 100-107
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Abstract
Ämnesord
Stäng
- Objectives: Pericarditis, takotsubo cardiomyopathy and early repolarization syndrome (ERS) are well-known to mimic ST elevation myocardial infarction (STEMI). We aimed to study whether ECG findings of reciprocal ST depression, PR depression, ST-segment convexity or terminal QRS distortion can discriminate between ST elevation due to ischemia and non-ischemic conditions. Design: Eighty-five patients with STEMI and 94 patients with non-ischemic ST elevation were included. All patients had acute chest pain and at least 0.1 mV ST elevation. Presence of PR depression, ST-segment convexity, terminal QRS distortion or reciprocal ST depression was assessed in each ECG. Results: In anterior ST elevation, ST depression in lead II (≥0.025 mV) occurred in 40% of patients with STEMI but in none of the non-ischemic cases. In inferior ST elevation, ST depression in lead I (≥0.025 mV) was present in 83% of patients with STEMI but in none of the non-ischemic cases. Chest-lead PR depression was uncommon in STEMI (12%) compared to non-ischemic cases (38%; p < .001). Convex ST elevation occurred in 22% of STEMI cases and in 9% of non-ischemic cases (p = .01). Terminal QRS distortion was more prevalent in STEMI (40%) than in non-ischemic ST elevation (7%). In multivariable analysis, reciprocal ST depression was associated with an ischemic diagnosis, whereas ST depression in aVR and chest-lead PR depression were associated with a non-ischemic diagnosis. Conclusions: Identification of true STEMI among patients with different ST-elevation etiology may be improved by considering reciprocal ST depression, ST depression in aVR and chest-lead PR depression.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- Electrocardiogram
- ECG
- Ischemia
- Chest pain
- Elektrokardiogram
- EKG
- Ischemi
- Bröstsmärta
Publikations- och innehållstyp
- art (ämneskategori)
- ref (ämneskategori)
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