OBJECTIVES: Patients with ST elevation (STE) in ≥ 2 leads or ST depression (STD) confined to V₁-V₄ are defined as potential STE myocardial infarction (STEMI). We evaluated the incidence of missed STEMI over an 11-month period. METHODS: Consecutive patients with a discharge diagnosis of non STEMI were retrospectively evaluated. Clinical data, ECG and angiographic data were reviewed. RESULTS: Of the 198 patients screened, 140 were included. Forty-nine patients (35%) met the STEMI criteria: 6 (12%) had STD confined to V₁-V₃, 20 (41%) had STD in V₁-V₆, 7 (14%) had STE in V₁-V₃, 2 (4%) had STE in I and aVL, 11 (22%) had STE in inferior leads, and 6 (12%) had STE in V₄-V₆. CONCLUSIONS: A significant percentage of patients met STEMI ECG criteria. A large number of patients with STD in V₁-V₆ had angiographic evidence compatible with inferolateral (posterior) STEMI equivalent.
OBJECTIVES:Patients with ST elevation (STE) in ≥ 2 leads or ST depression (STD) confined to V₁-V₄ are defined as potential STE myocardial infarction (STEMI). We evaluated the incidence of missed STEMI over an 11-month period. METHODS: Consecutive patients with a discharge diagnosis of non STEMI were retrospectively evaluated. Clinical data, ECG and angiographic data were reviewed. RESULTS: Of the 198 patients screened, 140 were included. Forty-nine patients (35%) met the STEMI criteria: 6 (12%) had STD confined to V₁-V₃, 20 (41%) had STD in V₁-V₆, 7 (14%) had STE in V₁-V₃, 2 (4%) had STE in I and aVL, 11 (22%) had STE in inferior leads, and 6 (12%) had STE in V₄-V₆. CONCLUSIONS: A significant percentage of patients met STEMI ECG criteria. A large number of patients with STD in V₁-V₆ had angiographic evidence compatible with inferolateral (posterior) STEMI equivalent.
Authors: Naoki Misumida; Akihiro Kobayashi; John T Fox; Sam Hanon; Paul Schweitzer; Yumiko Kanei Journal: Ann Noninvasive Electrocardiol Date: 2015-04-17 Impact factor: 1.468