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High-risk electrocardiogram presentations in the acute coronary syndrome patient - Beyond ST-segment elevation myocardial infarction.
Turk J Emerg Med
January 2025
Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA.
This review considers high-risk electrocardiographic patterns in the acute coronary syndrome (ACS) patient; we review 7 electrocardiogram presentations lacking diagnostic criteria for ST-segment elevation myocardial infarction (STEMI) yet likely representing either STEMI equivalent syndromes or ACS presentations with significant short-and long-term risk. The STEMI equivalent presentations include acute posterior wall myocardial infarction, the hyperacute T-wave of early STEMI, de Winter syndrome, first diagonal of the left anterior descending artery occlusion, and left bundle branch block modified Sgarbossa positive findings. High-risk presentation, not felt to be STEMI equivalent entities yet still possessing significant risk of short-and long-term adverse outcome, include lead aVR ST-segment elevation and Wellens syndrome.
View Article and Find Full Text PDFPrevalence and Prognostic Impact of ST Segment Elevation in Lead aVR Among Patients with Cardiac Arrest.
Eur Heart J Acute Cardiovasc Care
January 2025
Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT.
Background: In acute coronary syndrome, ST-segment elevation in lead aVR (STE-aVR) indicates global myocardial ischemia, often related to multivessel or severe left main disease, and correlates with increased mortality. The prevalence and prognostic significance of STE-aVR in cardiac arrest (CA) patients is unknown.
Methods: We identified patients (≥18 years) with CA between 2011 to 2022 who achieved return of spontaneous circulation (ROSC).
The Prognostic Significance of QTc Prolongation in Lead aVR in Patients with Acute Coronary Syndrome with ST Elevation or Depression.
Medicina (Kaunas)
December 2024
Department of Emergency Medicine, Faculty of Medicine, Gaziantep University, Gaziantep 27410, Turkey.
: In patients with acute coronary syndrome, electrocardiographic parameters, including ST elevation in lead aVR (aVR-STE), ST depression (aVR-STD), and QTc prolongation, are crucial. This study aims to show the predictive value of a longer QTc in emergency department patients with acute coronary syndrome and ≥1 mm ST elevation or depression in the aVR lead in electrocardiography. : A retrospective analysis was conducted on 1273 patients admitted to the emergency department with a preliminary diagnosis of acute coronary syndrome between 2020 and 2023.
View Article and Find Full Text PDFDataset and analysis of automated and manual methods to differentiate wide QRS complex tachycardias.
Data Brief
February 2025
Department of Medicine, Division of Cardiovascular Diseases, Washington University School of Medicine in St. Louis, St. Louis, MO, United States.
Article Synopsis
- Differentiating between ventricular tachycardia (VT) and supraventricular wide tachycardia (SWCT) using 12-lead ECG is challenging and has traditionally depended on manual interpretation, which can be limited by the user's expertise.
- Recent research has introduced automated algorithms that may offer improved accuracy over manual methods, but there has been little direct comparison between these two approaches.
- A study by LoCoco et al. (2024) evaluated the effectiveness of traditional manual ECG differentiation methods against five automated algorithms, analyzing 213 ECGs to assess their diagnostic performance.
Acute myocardial infarction with ST elevation isolated to lead III (and aVR).
J Electrocardiol
December 2024
Faculty of Medicine and Life Sciences, Tampere University, and Heart Center, Tampere University Hospital, Tampere, Finland.
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