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Related Concept Videos

Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

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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...
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Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

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The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
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Acute Coronary Syndrome III: Diagnostic Studies01:30

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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...
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Acute Coronary Syndrome IV: Interprofessional Care01:28

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IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
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Disturbances in Heart Rhythm01:29

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Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
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Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
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Updated: Jan 10, 2026

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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Risk Factors for QRS-Fragmentation in Patients with STEMI Undergoing PCI.

Florian Tinhofer1,2,3, Rosana Rakhimova4, Elena A Badykova4

  • 13rd Medical Department with Cardiology and Intensive Care Medicine, Clinic Ottakring, 1160 Vienna, Austria.

Medicina (Kaunas, Lithuania)
|November 27, 2025
PubMed
Summary
This summary is machine-generated.

Fragmentation of the QRS complex (fQRS) in ST-elevation myocardial infarction (STEMI) patients undergoing PCI is linked to elevated C-reactive protein (CRP) levels. This suggests fQRS may indicate significant inflammation during myocardial ischemia.

Keywords:
ACSECGSTEMIfragmented QRS

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Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Clinical Research

Background:

  • ST-elevation myocardial infarction (STEMI) remains a leading cause of cardiovascular mortality globally.
  • Early risk stratification is vital for effective STEMI management, particularly in resource-limited settings.
  • QRS fragmentation (fQRS) is an emerging electrocardiographic marker with prognostic implications in STEMI.

Purpose of the Study:

  • To investigate the underlying mechanisms and risk factors associated with fQRS occurrence in STEMI patients undergoing primary percutaneous coronary intervention (pPCI).
  • To analyze the correlation between fQRS and various clinical and biochemical parameters in STEMI patients post-pPCI.

Main Methods:

  • A cohort of 122 STEMI patients undergoing pPCI between September 2020 and June 2021 were analyzed.
  • fQRS occurrence was assessed and correlated with clinical data and biochemical markers, including C-reactive protein (CRP) and glomerular filtration rate (GFR).
  • Univariable and multivariable logistic regression models were employed to identify independent predictors of fQRS.

Main Results:

  • The fQRS pattern was observed in 33.6% of the studied STEMI patients.
  • Univariable analysis revealed significant associations between fQRS and both GFR (p=0.050) and CRP levels (p=0.014).
  • Multivariable analysis confirmed that only elevated CRP levels on admission were independently associated with the presence of fQRS (OR=3.44, p=0.029).

Conclusions:

  • A significant correlation exists between fQRS and CRP levels in STEMI patients treated with pPCI.
  • fQRS may serve as a valuable indicator of extensive inflammation in the context of myocardial ischemia.
  • Further research could explore fQRS's role in risk stratification and guiding therapeutic interventions in STEMI.