Prognostic value of exercise-induced QT dispersion in patients after acute myocardial infarction.

Background: Electrocardiographic exercise tests are widely recommended for patients before discharge after myocardial infarction, what justify the search for new variables which may improve their prognostic value. QT dispersion in 12 lead ECG reflects the heterogeneity of ventricular repolarisation. Increased QT dispersion is a noninvasive marker of ischaemia and electrical instability.

Low serum triiodothyronine in acute myocardial infarction indicates major heart injury.

Aims: In patients with acute myocardial infarction (MI), low serum triiodothyronine (T3) concentration is commonly associated with a severe clinical course. The aim of this prospective study was to investigate whether a severe clinical course in patients with low T3 is related to the magnitude of myocardial injury assessed by echocardiography.

Methods And Results: Out of 635 patients with MI we enrolled 100 consecutive patients.

Acute coronary syndrome: potassium, magnesium and cardiac arrhythmia.

Background: Cardiac arrhythmia is often present in patients with acute coronary syndrome (ACS) and may be due to the electrolyte imbalance.

Aim: To assess the prevalence and clinical significance of electrolyte imbalance in ACS.

Methods: Serum potassium and magnesium levels were measured within the first few hours in 204 consecutive patients with ACS admitted to our department over a period of 23 months.

Is preinfarction angina associated with better outcome after myocardial infarction?

Background: In a clinical setting of acute myocardial infarction (MI), short-lasting and transient anginal pain, preceding the development of acute MI, is regarded as a symptom representing ischaemic preconditioning. Some experimental and clinical data suggested that preinfarction angina may favourably influence the course of acute MI.

Aim: We sought to examine the hypothesis that preinfarction angina occurring within 24 hours prior to the onset of acute MI favourably influences the outcome.

Antioxidant vitamins decrease exercise-induced QT dispersion after myocardial infarction.

Background: Antioxidant vitamins C and E inhibit neutrophil-mediated production of free radicals in acute myocardial infarction (MI) which may limit MI size and improve myocardial perfusion.

Aim: To examine whether treatment with vitamin C and E reduces inhomogeneity of repolarisation in patients with acute MI.

Methods: In this double-blind, placebo-controlled randomised trial 37 patients with acute MI were enrolled and assigned to vitamin C and E (600 mg/day each) or placebo treatment, starting on the first day of acute MI and lasting for 14 days.

Is chest pain still the most important symptom of acute coronary syndrome?

Background: Acute coronary syndrome (ACS) carries the risk of death due to electrical or haemodynamical disturbances. Thus, rapid in-hospital treatment is necessary. To achieve this, a patient, his family and his physician should correctly diagnose ACS, based mainly on clinical symptoms.