Correlation between Electrocardiogram and Coronary Angiography in ACS with Persistent ST Segment Elevation: Institutional Cross-sectional Study
Asian Journal of Research in Cardiovascular Diseases,
Background: The electrocardiogram provides more information on the exact location of the lesion, prediction of the final infarct size, and estimation of the prognosis. Nevertheless, coronary angiography remains the gold standard for identifying the culprit artery. The aim of our work is to study the correlation between electrical and coronary data and to determine the reproducibility of the electrocardiogram in the identification of the culprit lesion.
Methods: This is a retrospective study of 91 cases of ST+ ACS, collected in the cardiology department B of the Souissi maternity hospital over a 6-month period.
Results: The mean age of the general population was 59.5 ± 9.2 years with 78% men and 22% women, 80% of whom were menopausal. The percentage of patients with typical infarct chest pain was 95%.
Electrically, the electrocardiogram showed ST-segment elevation in all patients. The anterior territory was affected in 64.8% of cases, nearly half of which were extensive anterior. The inferior territory was affected in 25 patients (27.5%).
Angiographic analysis of the lesions showed monotruncal coronary involvement in almost half of the cases. The majority of cases (65.6%) involved the anterior interventricular artery.
Conclusions: The ECG remains an essential tool in the early identification of the artery responsible for the infarction to guide the revascularisation procedure.
The combination of ECG and coronary angiography is essential for better assessment of acute myocardial infarction in order to optimize its management.
- coronary angiography
How to Cite
Bates ER, Clemmensen PM, Califf RM, Gormon LE, Aronson LG, George BS et al, Precordial ST- segment depression predicts a worse prognosis in inferior infarction despite reperfusion therapy. J Am Coll Cardio.1990;16:1538-1544.
Blanke H, Cohen M, Schlueter GU, et al. Electrocardiographic and coronary arteriographic correlations during acute myocardial infarction. Am J Cardiol. 1984;(54):249–255.
Thygesen K, Alpert JS, White HD. Universal definition of myocardial infarction. J Am Coll Cardiol. 2007;50: 2173-95.
Katy Perlemuter, Gilles Montalescot, infarctus du myocarde faculté de médecine paris-ile-de- france-ouest.
Cooksey JD, Dunn M, Massie E. Inferoposterior myocardial infarction. Clinical Vectrocardiography and Electrocardiography. Chicago: Year Book Medical Publishers, 1977: 391-427.
Berry C, Zalewski A, Kovach R. Surface electrocardiogram ischemia during coronary artery occlusion. Am J Cardiol. 1989;63:21–26.
Gupta, A, Lokhandwala, YY, Kerkar, PG, et al Electrocardiographic differentiation between right coronary and left circumflex coronary arterial occlusion in isolated inferior wall myocardial infarction. Indian Heart J. 1999;51:281-284.
Einthoven W. Le telecardiogramme. Arch Int de Physiol. 1906; 4:132- 164 (translated into English. Am Heart J. 1957;53: 602-615.
Lancet et suivantes. Einthoven décrit un triangle équilatéral formé par les dérivations standards D1, D2, D3, appelé plus tard "triangle d'Einthoven”. 1912; 853.
Vincent GM, Abildskov JA, Burgess MJ. Mechanisms of ischemic ST-segment displacement. Evaluation by direct current recordings. Circulation. 1977;56 (4 Pt 1):559–66.
Kusumoto FM. Cardiovascular Pathophysiology. Paperback. Hayes Barton Press. 2004;304.
Baltazar RF. Basic and Bedside Electrocardiography. Lippincott Williams &Wilkins. 2009;468.
Thygesen K, Alpert JS, White HD. Universal definition of myocardial infarction. EurHeart J. 2007;28:2525– 2538.
Kristian Thygesen; Joseph S. Alpert; et all. White ESC/ACCF/AHA/WHF Expert Consensus Document, Third Universal Definition of Myocardial Infarction. Circulation. 2012;126:2020-2035.
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