Document Detail

Manual measurement of QT dispersion in patients with acute myocardial infarction and nondiagnostic electrocardiograms.
MedLine Citation:
PMID:  12153894     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine whether manually measured QT dispersion (QTD) may be a useful diagnostic adjunct for acute myocardial infarction (AMI) in emergency department patients with chest pain (CP) and nondiagnostic initial electrocardiograms (ECGs). METHODS: This was a retrospective review of a cohort of patients admitted to the coronary triage unit (CTU) at a large urban facility over a two-year period (1997-1999). Cases included all patients with nondiagnostic initial ECGs diagnosed as having AMI by enzymatic criteria. Controls consisted of patients admitted to the CTU who received a final diagnosis of "musculoskeletal pain" at discharge. The QT intervals were measured on the ECGs obtained on presentation. The ECGs were included only if the QT interval could be measured on at least eight out of 12 leads. The QTD was calculated as the difference between the longest and shortest QT intervals in all measured leads. All measurements and calculations were done by a single individual. The QTDs were compared for cases versus controls using 50 msec as a cutoff for the presence of AMI. RESULTS: The study cohort consisted of 36 cases and 124 controls. The QTDs between the two groups were markedly different, with the mean for the cases at 85.5 msec [range: 40 to 200; +/-standard deviation (SD) = 39.6] and for the controls 47.1 msec (range: 0 to 120; +/-SD = 20.4). The unadjusted odds ratio (OR) of having a QTD greater than 50 msec in the setting of AMI and a nondiagnostic initial ECG in this cohort was 11.9 [95% confidence interval (95% CI) = 5.0 to 28.4; p < 0.0001] and was 12.5 (95% CI = 4.8 to 32.3; p < 0.0001) adjusted for age, gender, and ethnicity. CONCLUSIONS: Manually measured QTD is significantly greater in patients with AMI and nondiagnostic ECGs versus healthy controls with musculoskeletal CP. Along with other data, QTD may serve as a useful diagnostic and decision-making tool in patients with acute CP and nondiagnostic ECGs.
Kirsten K Calder; Chris Tomongin; William K Mallon; Tammy Genna; Philip Bretsky; Sean O Henderson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Academic emergency medicine : official journal of the Society for Academic Emergency Medicine     Volume:  9     ISSN:  1069-6563     ISO Abbreviation:  Acad Emerg Med     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-08-02     Completed Date:  2002-09-10     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9418450     Medline TA:  Acad Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  851-4     Citation Subset:  IM    
Department of Emergency Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.
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MeSH Terms
Case-Control Studies
Emergency Service, Hospital
Middle Aged
Myocardial Infarction / diagnosis*
Retrospective Studies

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