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

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Temporal electrocardiographic changes in anterior ST elevation myocardial infarction versus the Takotsubo syndrome

Rickard Zeijlon1,2,3, Sandeep Jha1,3, Vina Le3

  • 1Department of Cardiology, Sahlgrenska University Hospital/S, Gothenburg, Sweden.

International Journal of Cardiology. Heart & Vasculature
|March 2, 2023
PubMed

Insights

Temporal electrocardiography (ECG) patterns in female ST-elevation myocardial infarction (STEMI) and Takotsubo syndrome (TTS) patients show similarities in T-wave inversion and Q-wave pathology. This suggests a transient ischemic pattern in female TTS.

Area of Science:

  • Cardiology
  • Medical Diagnostics
  • Clinical Research

Background:

  • Electrocardiography (ECG) on admission shows similarities between ST-elevation myocardial infarction (STEMI) and Takotsubo syndrome (TTS).
  • Limited research exists on temporal ECG comparisons between STEMI and TTS.
  • This study focuses on comparing ECG changes from admission to day 30 in anterior STEMI versus female TTS patients.

Purpose of the Study:

  • To compare temporal ECG findings between female anterior STEMI and female TTS patients.
  • To analyze ECG evolution from admission to day 30.
  • To investigate differences and similarities in ECG patterns between these conditions, including sex-based comparisons in STEMI.

Main Methods:

  • Prospective enrollment of adult patients with anterior STEMI or TTS at Sahlgrenska University Hospital (December 2019 - June 2022).
  • Analysis of baseline characteristics, clinical variables, and serial ECGs from admission to day 30.
  • Utilized a mixed-effects model for temporal ECG comparison between female anterior STEMI and female TTS, and between female and male anterior STEMI patients.

Main Results:

  • Included 101 anterior STEMI patients (31 female, 70 male) and 34 TTS patients (29 female, 5 male).
  • Temporal T-wave inversion patterns were similar between female anterior STEMI and female TTS, and between female and male anterior STEMI.
  • ST elevation was more frequent in anterior STEMI, while QT prolongation was less common compared to TTS. Q-wave pathology was more similar between female anterior STEMI and female TTS than between female and male anterior STEMI.

Conclusions:

  • The temporal evolution of T-wave inversion and Q-wave pathology from admission to day 30 is similar in female anterior STEMI and female TTS patients.
  • Temporal ECG findings in female TTS patients may reflect a "transient ischemic" pattern.
  • These findings contribute to differentiating between STEMI and TTS using serial ECG analysis, particularly in female patients.
Abstract

Keywords:
ElectrocardiographyST elevation myocardial infarctionTakotsubo syndrome

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