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Dtsch. Med. Wochenschr. · Mar 2020
Case Reports[STEMI equivalents on the ECG - a case-based presentation].
- Dominik Beckenbauer, Valeria Martínez Pereyra, and Peter Ong.
- Dtsch. Med. Wochenschr. 2020 Mar 1; 145 (5): 318-326.
AbstractThe 12-lead resting ECG remains an indispensable diagnostic tool in patients with acute chest pain. This is particularly important as the identification of ST-segment elevations leads to the diagnosis of ST-segment elevation myocardial infarction (STEMI) and subsequent, immediate coronary reperfusion (usually via primary PCI). However, correct interpretation of the 12-lead ECG in patients with acute chest pain remains challenging. Apart from "classical" ST-segment elevations there are several "equivalents" in the ECG pointing towards an acute coronary occlusion. Among these, hyperacute T-waves, subtle ST-segment elevations, ST-segment elevation in leads aVR/V1 with concomitant ST-segment depression in ≥ 8 other leads and high R-peak with positive T-waves combined with horizontal ST-segment depression in leads V1/V2 can be found. This article provides a case-based presentation of STEMI equivalents on the ECG in order to improve correct ECG interpretation and prognosis of such patients.© Georg Thieme Verlag KG Stuttgart · New York.
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