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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

Acute non-Q wave myocardial infarction associated with early ST segment elevation: evidence for spontaneous coronary

B L Huey, M Gheorghiade, R S Crampton

    Journal of the American College of Cardiology
    |January 1, 1987
    PubMed

    Insights

    Early ST segment elevation in non-Q wave myocardial infarction indicates a smaller infarct size and better left ventricular function. This finding is significant for understanding infarct characteristics and patient prognosis.

    Area of Science:

    • Cardiology
    • Clinical Medicine
    • Biomedical Engineering

    Background:

    • The clinical significance of early ST segment elevation in non-Q wave myocardial infarction (MI) remains unclear.
    • ST segment elevation on admission electrocardiograms (ECGs) is typically associated with ST-elevation MI (STEMI).

    Purpose of the Study:

    • To investigate the clinical significance of early ST segment elevation in patients with non-Q wave MI.
    • To correlate ST segment elevation characteristics with infarct size and left ventricular function.

    Main Methods:

    • Analysis of 150 patients with acute myocardial infarction and ST elevation ≥1 mm in contiguous leads.
    • Classification of infarcts into Q wave (n=115) and non-Q wave (n=35) based on serial ECGs.
    • Predischarge assessment including angiography, radionuclide ventriculography, and exercise thallium-201 scintigraphy.

    Main Results:

    • Non-Q wave MI patients showed significant ST elevation (3.1 ± 1.2 leads, 6.2 ± 6.2 mm sum) despite less than Q wave MI patients.
    • Non-Q wave MI was associated with shorter time to peak creatine kinase (CK), higher infarct vessel patency (57% vs 24%), lower peak CK values, and higher left ventricular ejection fraction (54 ± 9% vs 46 ± 12%).

    Conclusions:

    • Early ST segment elevation in non-Q wave MI is associated with favorable infarct characteristics.
    • These findings suggest that ST elevation on admission ECG may provide prognostic information even in non-Q wave MI.
    • Further research is warranted to elucidate the full implications of ST elevation in non-Q wave MI.

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