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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

Underlying cardiomyopathy in patients with ST-segment elevation in the right precordial leads

Hyungseop Kim1, Yongkeun Cho, Yonghwi Park

  • 1Division of Cardiology, Department of Internal Medicine, Kyungpook National University, Taegu, Korea.

Circulation Journal : Official Journal of the Japanese Circulation Society
|May 26, 2006
PubMed

Insights

ST-segment elevation in right precordial leads can indicate ventricular fibrillation (VF) and sudden death (SD). This study found underlying cardiomyopathy in over half of patients with these ECG changes, suggesting a link between cardiac abnormalities and these dangerous events.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Pathology

Background:

  • ST-segment elevation in right precordial leads is associated with ventricular fibrillation (VF) and sudden death (SD).
  • The underlying mechanisms for these cardiac events remain unclear.
  • This study investigated potential morphological or pathological abnormalities in affected patients.

Purpose of the Study:

  • To assess for underlying morphological or pathological abnormalities in patients presenting with ST-segment elevation in right precordial leads.
  • To clarify the mechanism of ventricular fibrillation and sudden death in this patient cohort.

Main Methods:

  • Cardiac evaluation of 14 consecutive male patients with ST-segment elevation (>2 mm) in right precordial leads.
  • Procedures included right ventriculography, endomyocardial biopsy, and assessment of ST-segment changes after sodium-channel blocker administration.
  • Coronary angiography was performed on all patients.

Main Results:

  • Cardiomyopathy was diagnosed in 7 patients (50%) via endomyocardial biopsy.
  • Right ventricular wall motion abnormalities were detected in 4 patients (29%).
  • Overall, 64% of patients exhibited wall motion abnormalities and/or pathological findings, with normal coronary angiograms in all.

Conclusions:

  • A significant proportion of patients with ST-segment elevation in right precordial leads have an underlying cardiomyopathy.
  • These findings suggest that cardiomyopathy is a key factor in the occurrence of ventricular fibrillation and sudden death in these individuals.
Abstract

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