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Related Experiment Videos

Reversible QRS changes during acute myocardial ischemia

B Surawicz1

  • 1Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, USA.

Journal of Electrocardiology
|July 31, 1998
PubMed
Summary
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Reversible QRS complex changes during acute myocardial infarction (AMI) are common and linked to ST-segment shifts. These QRS alterations, often affecting the terminal portion, indicate intraventricular conduction disturbances during ischemia.

Area of Science:

  • Cardiology
  • Electrocardiography
  • Medical Diagnostics

Background:

  • Reversible QRS complex changes during acute myocardial infarction (AMI) are infrequently reported.
  • Systematic analysis of these electrocardiographic findings in a large patient cohort is lacking.

Purpose of the Study:

  • To systematically analyze reversible QRS complex changes in patients with acute myocardial infarction.
  • To characterize the specific types and prevalence of QRS alterations during AMI.

Main Methods:

  • Retrospective analysis of electrocardiograms from 29 patients with documented AMI and reversible QRS changes.
  • Detailed measurement of ST-segment deviation, QRS complex morphology, duration, and U wave amplitude.

Main Results:

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  • Reversible QRS changes were observed in all 29 patients, with terminal QRS portion changes occurring in 100% and initial QRS portion changes in 79%.
  • Specific changes included increased S amplitude (62%), increased R amplitude (31%), and QS to qRS/qR transformation (21%).
  • Increased QRS duration was noted in 4 patients.

Conclusions:

  • Reversible QRS changes are a frequent finding during AMI, not just isolated occurrences.
  • These changes are attributed to passive pull from ST-segment shifts and associated intraventricular conduction disturbances.