TY - JOUR
T1 - Diagnosis of myocardial infarction-induced ventricular aneurysm in the presence of complete left bundle branch block
AU - Madias, John E.
AU - Ashtiani, Ramin
AU - Agarwal, Himanshu
AU - Win, Moethu
AU - Narayan, Virenjan K.
AU - Sinha, Anjan
PY - 2001/4
Y1 - 2001/4
N2 - An analysis of the 4,196 files of our Cardiology Clinic cohort showed 128 patients with a complete left bundle branch block (LBBB) in their electrocardiograms (ECGs). Of these patients, 27 had suffered a myocardial infarction in the past and had been found to have a ventricular aneurysm (VA), documented by ≥1 of several noninvasive and invasive diagnostic methods. Five of these 27 patients had stable ST-segment elevation in ≥1 of left precordial ECG leads, with predominantly positive QRS complexes (an ECG criterion for the diagnosis of VA in the presence of LBBB, which we have recently described). The sensitivity of this ECG criterion for the diagnosis of VA was 18.5%, and the specificity was 100%. The frequency of distribution of VA in the septal, and even more, apical myocardial regions was higher in the patients with a positive ECG diagnosis of VA, than in the patients with a negative one (P = .049, and P = .009, correspondingly). The number of myocardial territories involved with a VA was not different in the 2 subgroups (P = .325). Pathophysiologically, this ECG alteration diagnostic of VA represents a superimposition of the primary ST-segment elevation due to the VA, on the expected secondary ST-segment depression due to the LBBB, and represents a summation effect.
AB - An analysis of the 4,196 files of our Cardiology Clinic cohort showed 128 patients with a complete left bundle branch block (LBBB) in their electrocardiograms (ECGs). Of these patients, 27 had suffered a myocardial infarction in the past and had been found to have a ventricular aneurysm (VA), documented by ≥1 of several noninvasive and invasive diagnostic methods. Five of these 27 patients had stable ST-segment elevation in ≥1 of left precordial ECG leads, with predominantly positive QRS complexes (an ECG criterion for the diagnosis of VA in the presence of LBBB, which we have recently described). The sensitivity of this ECG criterion for the diagnosis of VA was 18.5%, and the specificity was 100%. The frequency of distribution of VA in the septal, and even more, apical myocardial regions was higher in the patients with a positive ECG diagnosis of VA, than in the patients with a negative one (P = .049, and P = .009, correspondingly). The number of myocardial territories involved with a VA was not different in the 2 subgroups (P = .325). Pathophysiologically, this ECG alteration diagnostic of VA represents a superimposition of the primary ST-segment elevation due to the VA, on the expected secondary ST-segment depression due to the LBBB, and represents a summation effect.
KW - ECG
KW - Left bundle branch block
KW - Myocardial infarction
KW - Ventricular aneurysm
UR - http://www.scopus.com/inward/record.url?scp=0035305506&partnerID=8YFLogxK
U2 - 10.1054/jelc.2001.23357
DO - 10.1054/jelc.2001.23357
M3 - Article
C2 - 11320463
AN - SCOPUS:0035305506
SN - 0022-0736
VL - 34
SP - 147
EP - 154
JO - Journal of Electrocardiology
JF - Journal of Electrocardiology
IS - 2
ER -