Document Detail


Supine vs semirecumbent and upright 12-lead electrocardiogram: does change in body position alter the electrocardiographic interpretation for ischemia?
MedLine Citation:
PMID:  17870476     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The goal of this study was to determine if a change in body position alters the 12-lead electrocardiographic (ECG) interpretation for ischemia and ST-segment elevation, the latter having direct implications for initial patient management in the emergency department. METHODS: Twelve-lead ECGs were sequentially obtained from a convenience sample of healthy adult volunteers in 3 positions (supine, 0 degrees; inclined, 45 degrees; and upright, 90 degrees). The tracings were randomized, blinded, and then independently read by 2 trained emergency medicine physicians who also assessed for the presence of ischemia and ST-segment elevation myocardial infarction. RESULTS: Seventy-five subjects were enrolled, with 7 (9%; 95% confidence interval [CI], 4-18) having ischemia on the supine ECG, 9 (12%; 95% CI, 6-22) on the incline, and 9 on the upright tracings. ST-segment elevation myocardial infarction pattern was present on 2 (3%; 95% CI, 0-9) supine, 2 inclined, and 2 upright ECGs. CONCLUSIONS: Changes in body position result in some ischemic variations of the 12-lead ECG.
Authors:
Robert H Baevsky; Marc D Haber; Fidela S Blank; Howard Smithline
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  25     ISSN:  1532-8171     ISO Abbreviation:  Am J Emerg Med     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-09-17     Completed Date:  2007-10-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  753-6     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, Tufts University School of Medicine, Baystate Medical Center, Springfield, MA 01199, USA. robert.baevsky@bhs.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Electrocardiography / methods*
Emergency Service, Hospital
Female
Humans
Male
Middle Aged
Myocardial Ischemia / diagnosis*,  physiopathology*
Observer Variation
Posture*
Predictive Value of Tests
Single-Blind Method

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


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