Particular electrocardiographic phenotypes in acute coronary syndromes
Despite continuous efforts in early recognition and timely management, acute coronary syndromes (ACS) continue to be the most common cause of death worldwide. The electrocardiogram (ECG) is the fastest, repeatable and most accesible instrument with diagnostic value, prognostic significance and ther...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Amaltea Medical Publishing House
2020-03-01
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| Series: | Romanian Medical Journal |
| Subjects: | |
| Online Access: | https://rmj.com.ro/articles/2020.1/RMJ_2020_1_Art-03.pdf |
| _version_ | 1797333422299938816 |
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| author | Anamaria Avram Radu Brezeanu Alexandru Iancu Valentin Chioncel Catalina Andrei Crina Sinescu |
| author_facet | Anamaria Avram Radu Brezeanu Alexandru Iancu Valentin Chioncel Catalina Andrei Crina Sinescu |
| author_sort | Anamaria Avram |
| collection | DOAJ |
| description | Despite continuous efforts in early recognition and timely management, acute coronary syndromes (ACS) continue to be the most common cause of death worldwide.
The electrocardiogram (ECG) is the fastest, repeatable and most accesible instrument with diagnostic value, prognostic significance and therapeutic implications.
Based on the ECG, ACS are divided into ST segment elevation myocardial infarction (STEMI) and non-ST segment elevation ACS (NSTEACS). Current guidelines recommend emergency reperfusion theraphy only in patients with STEMI. Conventional criteria for the diagnosis of STEMI exclude the patients with atypical ECG findings, correlated with an increased risk of transmural myocardial infarction and considered STEMI equivalents. These particular ECG phenotypes are: new or presumably new bundle branch block, ST segment
elevation in aVR, isolated posterior myocardial infarction, de Winter T waves, Wellens syndrome and ischaemia induced Brugada phenocopy. Rapid risk stratification in patients with NSTEACS is crucial for adequate management. The particular ECG phenotypes discussed herein proove the need to redefine the signs of the present or iminent coronary artery
occlusion, especially the left anterior descending (LAD) artery, because many patient may benefit from early invasive treatment instead of conservative pharmacological treatment. |
| first_indexed | 2024-03-08T08:03:34Z |
| format | Article |
| id | doaj.art-6c9a4446f73c48f9ab0c760fc7b36f13 |
| institution | Directory Open Access Journal |
| issn | 1220-5478 2069-606X |
| language | English |
| last_indexed | 2024-03-08T08:03:34Z |
| publishDate | 2020-03-01 |
| publisher | Amaltea Medical Publishing House |
| record_format | Article |
| series | Romanian Medical Journal |
| spelling | doaj.art-6c9a4446f73c48f9ab0c760fc7b36f132024-02-02T11:40:55ZengAmaltea Medical Publishing HouseRomanian Medical Journal1220-54782069-606X2020-03-01671142210.37897/RMJ.2020.1.3Particular electrocardiographic phenotypes in acute coronary syndromesAnamaria Avram0Radu Brezeanu1Alexandru Iancu2Valentin Chioncel3Catalina Andrei4Crina Sinescu5“Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; “Bagdasar-Arseni” Emergency Clinical Hospital, Bucharest, Romania “Bagdasar-Arseni” Emergency Clinical Hospital, Bucharest, Romania“Bagdasar-Arseni” Emergency Clinical Hospital, Bucharest, Romania“Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; “Bagdasar-Arseni” Emergency Clinical Hospital, Bucharest, Romania“Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; “Bagdasar-Arseni” Emergency Clinical Hospital, Bucharest, Romania“Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; “Bagdasar-Arseni” Emergency Clinical Hospital, Bucharest, RomaniaDespite continuous efforts in early recognition and timely management, acute coronary syndromes (ACS) continue to be the most common cause of death worldwide. The electrocardiogram (ECG) is the fastest, repeatable and most accesible instrument with diagnostic value, prognostic significance and therapeutic implications. Based on the ECG, ACS are divided into ST segment elevation myocardial infarction (STEMI) and non-ST segment elevation ACS (NSTEACS). Current guidelines recommend emergency reperfusion theraphy only in patients with STEMI. Conventional criteria for the diagnosis of STEMI exclude the patients with atypical ECG findings, correlated with an increased risk of transmural myocardial infarction and considered STEMI equivalents. These particular ECG phenotypes are: new or presumably new bundle branch block, ST segment elevation in aVR, isolated posterior myocardial infarction, de Winter T waves, Wellens syndrome and ischaemia induced Brugada phenocopy. Rapid risk stratification in patients with NSTEACS is crucial for adequate management. The particular ECG phenotypes discussed herein proove the need to redefine the signs of the present or iminent coronary artery occlusion, especially the left anterior descending (LAD) artery, because many patient may benefit from early invasive treatment instead of conservative pharmacological treatment.https://rmj.com.ro/articles/2020.1/RMJ_2020_1_Art-03.pdfacute coronary syndromesrisk stratificationemergency reperfusion theraphystemi equivalents |
| spellingShingle | Anamaria Avram Radu Brezeanu Alexandru Iancu Valentin Chioncel Catalina Andrei Crina Sinescu Particular electrocardiographic phenotypes in acute coronary syndromes Romanian Medical Journal acute coronary syndromes risk stratification emergency reperfusion theraphy stemi equivalents |
| title | Particular electrocardiographic phenotypes in acute coronary syndromes |
| title_full | Particular electrocardiographic phenotypes in acute coronary syndromes |
| title_fullStr | Particular electrocardiographic phenotypes in acute coronary syndromes |
| title_full_unstemmed | Particular electrocardiographic phenotypes in acute coronary syndromes |
| title_short | Particular electrocardiographic phenotypes in acute coronary syndromes |
| title_sort | particular electrocardiographic phenotypes in acute coronary syndromes |
| topic | acute coronary syndromes risk stratification emergency reperfusion theraphy stemi equivalents |
| url | https://rmj.com.ro/articles/2020.1/RMJ_2020_1_Art-03.pdf |
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