Related Experiment Video

Updated: Jul 6, 2025

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

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Wandering ST-Segment in Acute Coronary Syndrome: The Einthoven's Twist

Bharath Raj Kidambi1, Sriram Veeraraghavan2, Soorampally Vijay3

  • 1Cardiology, All India Institute of Medical Sciences, New Delhi, Delhi, IND.

Cureus
|January 8, 2024
PubMed

Insights

ST-segment axis shifts in ST-elevation myocardial infarction (STEMI) can confuse diagnosis. This study presents two cases of wandering ST-segment axis in acute coronary syndrome, detailing their management.

Area of Science:

  • Cardiology
  • Electrocardiography
  • Acute Coronary Syndromes

Background:

  • The ST-segment axis in ST-elevation myocardial infarction (STEMI) is vital for identifying the affected artery and guiding revascularization.
  • Abrupt changes in ST-segment axis during patient management can lead to diagnostic uncertainty and treatment delays.

Observation:

  • This report details two cases of acute coronary syndrome (ACS) presenting with a wandering ST-segment axis.
  • Potential causes for ST-segment axis shifts include lead misplacement, evolving myocardial injury, coronary vasospasm, thrombus migration, and aortic dissection.

Findings:

  • The study focuses on the diagnostic challenges and clinical implications of a wandering ST-segment axis in ACS.
  • Management strategies for these complex cases are discussed, highlighting the importance of accurate interpretation.

Implications:

  • Understanding and recognizing wandering ST-segment axis is crucial for timely and accurate diagnosis in ACS.
  • Prompt identification can prevent unnecessary investigations and expedite appropriate treatment, improving patient outcomes.

Keywords:
anterior wall acute myocardial infarctioncoronary artery vasospasmelectrocardiogram (ecg/ekg)inferior wall myocardial infarctionlead misplacementocclusion miwandering myocardial infarction

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