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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com


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jueves, 4 de febrero de 2016

Five ECG Patterns You Must Know

R.E.B.E.L.EM - February 4, 2016 - Posted by Salim Rezaie
The electrocardiogram (ECG) is one of the most useful diagnostic studies for identification of acute coronary syndrome (ACS) and acute myocardial infarction (AMI). The classic teaching is ST-segment elevation myocardial infarction (STEMI) is defined as symptoms consistent with acute coronary syndrome (ACS) + new ST-segment elevation at the J point in at least 2 anatomically contiguous leads of at least 2mm (0.2mV) in men or at least 1.5mm in women in leads V2 – V3 and/or at least 1mm (0.1mV) in other contiguous leads or the limb leads, in the absence of a left bundle branch block, left ventricular hypertrophy, or other non-acute MI ST-segment elevation presentations. Unfortunately, the ECG may be non-diagnostic in nearly half of all patients who initially present with AMI. There are also STEMI equivalent patterns that are caused by occlusion of the coronary arteries that place a significant portion of the left ventricle at jeopardy and result in poor outcomes. This review article focused on 5 under recognized high-risk ECG patterns in the ACS patient that result in poor outcomes including malignant dysrhythmias, higher rates of cardiogenic shock, and death."
  • First Diagonal Branch of the Left Anterior Descending Artery Occlusion
  • De Winter’s T Waves
  • Left Main Coronary Artery Occlusion
  • Wellens’ Syndrome
  • Posterior Wall AMI