Comparing Door-To-Balloon Time between ST-Elevation Myocardial Infarction Electrocardiogram and Its Equivalents
Youngchul Choi1, Kiwook Kim1, Joo Suk Oh1
1Department of Emergency Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 271 Cheonbo-ro, Uijeongbu-si 11765, Korea.
Journal of Clinical Medicine
|October 14, 2022
Summary
Patients with ST-elevation myocardial infarction equivalents experienced longer door-to-balloon times. Prompt recognition of these atypical electrocardiographic findings is crucial for timely intervention and improved outcomes.
Area of Science:
- Cardiology
- Emergency Medicine
- Diagnostic Imaging
Background:
- Longer door-to-balloon (DTB) times in ST-elevation myocardial infarction (STEMI) correlate with poor patient outcomes.
- A subset of acute coronary occlusions presents with atypical electrocardiographic (ECG) findings, termed STEMI-equivalents.
- The impact of STEMI-equivalents on DTB times requires investigation.
Purpose of the Study:
- To determine if DTB times are delayed in patients with STEMI-equivalent ECGs compared to typical STEMI.
- To identify STEMI-equivalent ECG as an independent predictor of delayed DTB time.
Main Methods:
- Retrospective analysis of acute coronary syndrome patients undergoing primary percutaneous coronary intervention (pPCI).
- Classification of ECGs into STEMI and STEMI-equivalent groups.
- Comparison of DTB times and logistic regression analysis for predictors of delayed DTB (>90 min).
Main Results:
- STEMI-equivalent ECGs were identified in 12.8% of 180 patients.
- DTB time was significantly longer in STEMI-equivalent patients (89 min) versus STEMI patients (81 min; p=0.001).
- STEMI-equivalent ECG was an independent predictor of delayed DTB time (OR 4.692; p=0.004).
Conclusions:
- Patients with STEMI-equivalent ECGs experience significantly delayed DTB times.
- Early recognition of STEMI-equivalents by emergency physicians and interventional cardiologists is essential.
- Reducing DTB time in STEMI-equivalent cases may improve clinical outcomes.
Keywords:
ST-elevation myocardial infarctionacute coronary syndromecoronary occlusiondoor-to-balloon timeemergency departmentpercutaneous coronary interventionMore Related Videos
09:23Confirmation of Myocardial Ischemia and Reperfusion Injury in Mice Using Surface Pad Electrocardiography
Published on: November 24, 2016
13.4K
08:19Transthoracic Echocardiography to Assess Post-Resuscitation Left Ventricular Dysfunction After Acute Myocardial Infarction and Cardiac Arrest in Pigs
Published on: July 12, 2022
3.0K
Related Concept Videos
01:29Electrocardiogram
3.1K
An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
3.1K
01:24ECG Interpretation of Rhythms
3.0K
An electrocardiogram (ECG)graphically represents the heart's electrical activity on ECG paper or a monitor.
Components of the Electrocardiogram
The primary components of a normal ECG waveform in Normal sinus rhythm(NSR) include the P wave, PR interval, QRS complex, ST segment, T wave, and occasionally a U wave.
ECG waveforms are divided by vertical and horizontal lines at standard intervals.
The horizontal axis measures time and rate, and the vertical axis measures amplitude or voltage....
Components of the Electrocardiogram
The primary components of a normal ECG waveform in Normal sinus rhythm(NSR) include the P wave, PR interval, QRS complex, ST segment, T wave, and occasionally a U wave.
ECG waveforms are divided by vertical and horizontal lines at standard intervals.
The horizontal axis measures time and rate, and the vertical axis measures amplitude or voltage....
3.0K
01:25Correlation between ECG and Cardiac Cycle
7.9K
The electrical signals recorded on an electrocardiogram (ECG) occur before the mechanical processes of contraction and relaxation during the cardiac cycle.
A cardiac action potential originates in the SA node and spreads throughout the atria and the AV node in approximately 0.03 seconds. This results in the P wave in an ECG and triggers atrial contraction. The action potential is then briefly slowed at the AV node, allowing the atria to contract and fill the ventricles with blood before...
A cardiac action potential originates in the SA node and spreads throughout the atria and the AV node in approximately 0.03 seconds. This results in the P wave in an ECG and triggers atrial contraction. The action potential is then briefly slowed at the AV node, allowing the atria to contract and fill the ventricles with blood before...
7.9K
01:28Electrocardiogram Fundamentals
825
Introduction
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin...
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin...
825
01:30Acute Coronary Syndrome I: Introduction
57
Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
57
01:30Acute Coronary Syndrome III: Diagnostic Studies
20
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
20