Spontaneous course of ST-segment elevation in acute anterior myocardial infarction

Circulation
R EssenS Effert

Abstract

The spontaneous course of ST-segment elevation (sigmaST) in 24 patients with acute anterior myocardial infarction (AMI) was studied by precordial ST-segment mapping, which was recorded at 2-hour intervals during the first 48 hours after admission. Change of sigmaST between two registrations was expressed as mV/hr, and was compared with clinical and hemodynamic parameters, course of MB-CK curve, calculated infarct mass and arrhythmias. After an initial rapid increase, there was a decrease of sigmaST, which reaches a plateau-like curve approximately 12 hours after the onset of chest pain. A second new increase of sigmaST exceeding a value of 0.6 mV/hr correlates well with extension of necrosis, verified by re-elevation of MB-CK. During the first 2 days, extension of necrosis could be detected in 50% of our patients. As new ischemic episodes and extension of necrosis in AMI occur frequently and are promptly indicated by an increase of sigmaST, the physician should, while monitoring therapeutic interventions, concentrate on such a second increase rather than on a decrease of sigmaST (which may occur spontaneously), as has been suggested in most previous reports.

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Citations

May 1, 1981·Irish Journal of Medical Science·M M KhanJ Mackinnon
Jul 20, 2002·The American Journal of Cardiology·Maria Cecilia BahitGalen S Wagner
Sep 16, 2009·The American Journal of Emergency Medicine·Jose Victor Nable, William Brady
Dec 16, 1993·The American Journal of Cardiology·P KlootwijkM L Simoons
Oct 1, 1983·American Heart Journal·H OlthofK I Lie

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