Document Detail


False-positive posterior myocardial infarct criteria during left anterior descending coronary angioplasty.
MedLine Citation:
PMID:  2975319     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In reviewing ECG change during acute anterior myocardial infarction (AMI) and during transluminal coronary angioplasty of the left anterior descending (LAD) coronary artery, QRS changes mimicking posterior myocardial infarct (PMI) and false-positive points for PMI using the QRS infarct size scoring system were observed in about 20% of patients. Nineteen patients in whom a three-lead electrocardiogram (ECG) was continuously recorded during transluminal coronary angioplasty of a proximal left anterior descending (LAD) coronary artery were reviewed. All but two had significant ST-segment shifts in V2 within a few seconds of balloon occlusion of a proximal LAD. In many such patients the R wave amplitude in V2 measured from the PR segment baseline remained relatively stable and the S amplitude tracked with the J. point. However, of the 19 patients studied, 11 had transient QRS changes greater than could be accounted for by baseline shift alone and 4 had transient false-positive PMI points by QRS MI size score. Transient QRS changes were observed as follows: (1) significant increase in R waves and/or decrease in S waves in V2 due to right septal block (or conduction delay) occurred in 3 of 11 patients and was the cause of the false-positive criteria for PMI; (2) 5 of 11 patients had a major decrease in R waves in V2 due to left septal block; (3) 2 of 11 patients had both (1) and (2); and (4) 1 of 11 had transient frontal plane axis shifts with the QRS configuration of anterosuperior fascicular block plus right and left septal block.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
R H Selvester; N B Wagner; G S Wagner
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of electrocardiology     Volume:  21 Suppl     ISSN:  0022-0736     ISO Abbreviation:  J Electrocardiol     Publication Date:  1988  
Date Detail:
Created Date:  1989-03-09     Completed Date:  1989-03-09     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0153605     Medline TA:  J Electrocardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  S105-11     Citation Subset:  IM    
Affiliation:
Department of Medicine, University of Southern California/Rancho Los Amigos Medical Center, Downey 90242.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Balloon*
Coronary Disease / therapy
Coronary Vessels
Electrocardiography*
False Positive Reactions
Heart Conduction System / physiopathology*
Humans
Intraoperative Care
Monitoring, Physiologic*
Myocardial Infarction / diagnosis*
Grant Support
ID/Acronym/Agency:
HL-17670/HL/NHLBI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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