Document Detail


Reperfusion therapy for ST-segment elevation myocardial infarction: has ECG information been under-utilized?
MedLine Citation:
PMID:  24813345     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
This perspective makes a contentious viewpoint that ECG information is underutilized in ST-segment elevation myocardial infarction (STEMI) and the next breakthrough rests on its full utilization. This is to better diagnose difficult cases such as ST changes during bundle branch block, posterior ST elevation and right-sided ST elevation during normal conduction, and aVR ST elevation. More importantly, this is to better characterize the STEMI for tailored reperfusion. The proposal is to develop a system capable of recording from multiple electrodes that one can apply onto oneself, and having analysis coordinated centrally via phone-internet transmission. This provides 'longitudinal' in addition to 'cross-sectional' ECG information. STEMI will be classified on a gray-scale according to its potential size and speed of Q wave evolution. The hypothesis is that large rapidly progressive STEMI is best treated by on-site fibrinolysis with prompt transferral to a percutaneous coronary intervention center; while small stuttering STEMI is best treated by primary percutaneous coronary intervention despite a long delay.
Authors:
Cheuk-Kit Wong
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-5-12
Journal Detail:
Title:  Expert review of cardiovascular therapy     Volume:  -     ISSN:  1744-8344     ISO Abbreviation:  Expert Rev Cardiovasc Ther     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-5-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101182328     Medline TA:  Expert Rev Cardiovasc Ther     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1-11     Citation Subset:  -    
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