Friday, July 27, 2007

An important electrocardiographic differentiation in patients with acute STEMI

When examining the electrocardiogram, look at how the injury current distorts the second portion of the QRS for an important prognostic sign (American Heart Journal).

In anterior infarction does the S wave in V2 and V3 fail to dip below the isoelectric line? In inferior infarction is the ST takeoff (J point) greater than half way up the height of the R wave? These electrocardiographic findings indicate a worse outcome, in particular poor results from reperfusion efforts via systemic thrombolysis or catheter intervention.

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