The nonspecificity of ST-segment elevation ≥5.0 mm in V1-V3 in the diagnosis of acute myocardial infarction in the presence of ventricular paced rhythm

John E. Madias

doi:10.1016/j.jelectrocard.2004.01.008

The nonspecificity of ST-segment elevation ≥5.0 mm in V1-V3 in the diagnosis of acute myocardial infarction in the presence of ventricular paced rhythm

John E. Madias

Research output: Contribution to journal › Article › peer-review

13 Scopus citations

Abstract

The criterion of ST-segment elevation (+ST) ≥5.0 mm in leads V1-V3 for the diagnosis of acute myocardial infarction (AMI) in patients with paced ventricular rhythm lacks specificity, since it is also encountered in patients with pacemakers and QRS complexes of large amplitudes in leads V1-V3 but without an AMI. This report is based on 2 such patients with electronically-paced rhythms and excessive +ST who did not have an AMI although this diagnosis would have been made if proposed criteria had been strictly employed. Consequently, it is recommended that in such instances the amplitudes of QRS complexes are taken into account when ST-segment elevations in leads V1-V3 are used in the diagnostic algorithm of AMI.

Original language	English
Pages (from-to)	135-139
Number of pages	5
Journal	Journal of Electrocardiology
Volume	37
Issue number	2
DOIs	https://doi.org/10.1016/j.jelectrocard.2004.01.008
State	Published - Apr 2004
Externally published	Yes

Keywords

Differential diagnosis
Left bundle branch block
Myocardial infarction
Pacemakers
ST-segment elevation
Thrombolysis

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10.1016/j.jelectrocard.2004.01.008

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title = "The nonspecificity of ST-segment elevation ≥5.0 mm in V1-V3 in the diagnosis of acute myocardial infarction in the presence of ventricular paced rhythm",

abstract = "The criterion of ST-segment elevation (+ST) ≥5.0 mm in leads V1-V3 for the diagnosis of acute myocardial infarction (AMI) in patients with paced ventricular rhythm lacks specificity, since it is also encountered in patients with pacemakers and QRS complexes of large amplitudes in leads V1-V3 but without an AMI. This report is based on 2 such patients with electronically-paced rhythms and excessive +ST who did not have an AMI although this diagnosis would have been made if proposed criteria had been strictly employed. Consequently, it is recommended that in such instances the amplitudes of QRS complexes are taken into account when ST-segment elevations in leads V1-V3 are used in the diagnostic algorithm of AMI.",

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AB - The criterion of ST-segment elevation (+ST) ≥5.0 mm in leads V1-V3 for the diagnosis of acute myocardial infarction (AMI) in patients with paced ventricular rhythm lacks specificity, since it is also encountered in patients with pacemakers and QRS complexes of large amplitudes in leads V1-V3 but without an AMI. This report is based on 2 such patients with electronically-paced rhythms and excessive +ST who did not have an AMI although this diagnosis would have been made if proposed criteria had been strictly employed. Consequently, it is recommended that in such instances the amplitudes of QRS complexes are taken into account when ST-segment elevations in leads V1-V3 are used in the diagnostic algorithm of AMI.

KW - Differential diagnosis

KW - Left bundle branch block

KW - Myocardial infarction

KW - Pacemakers

KW - ST-segment elevation

KW - Thrombolysis

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The nonspecificity of ST-segment elevation ≥5.0 mm in V1-V3 in the diagnosis of acute myocardial infarction in the presence of ventricular paced rhythm

Abstract

Keywords

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