European heart journal
-
European heart journal · Jan 1993
ST segment depression in a VL: a sensitive marker for acute inferior myocardial infarction.
In a substantial percentage of patients with acute myocardial infarction, especially in those with inferior wall involvement, no ST elevation is detected on the electrocardiogram. In many of them, ST depression is found in leads oriented to remote segments of the heart. The importance of those reciprocal changes for early diagnosis of acute inferior myocardial infarction in patients without ST elevation has not been stressed. ⋯ Only three patients had no ST depression in aVL. In eight patients (7.5%) ST depression in aVL was the sole early electrocardiographic sign of the inferior infarction. aVL is the only lead that is facing the superior part of the left ventricle and thus is the only lead that is truly opponent to the inferior wall. It seems that ST depression in aVL, by contrast to that in the precordial leads, is found in the majority of patients with evolving inferior wall myocardial infarction and is not influenced by extension of the infarction to the right ventricle or to the posterior wall.(ABSTRACT TRUNCATED AT 250 WORDS)
-
European heart journal · Jan 1993
Intra-aortic balloon counterpulsation improves survival in cardiogenic shock complicating acute myocardial infarction.
The impact of intra-aortic balloon counterpulsation (IABC) on survival of patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) has been evaluated in this study of 85 patients. IABC was available for the 24 group A patients (and used in 20 patients). IABC was not available for the 21 group B patients who presented simultaneously with similar clinical characteristics and received identical pharmacological treatment. ⋯ During 1980-1984, 35 patients with AMI and CS received IABC (group C) but none underwent early revascularization. There was no difference in in-hospital or one-year survival between group A1 (50% and 40%) and group C (45% and 40%). We conclude that early IABC improves survival of patients with AMI complicated by CS.