{"title":"AMI(双心室起搏)-不要丢弃心电图。","authors":"T Versyck, D Devriese, S Smith, P Calle, C Borin","doi":"10.1080/17843286.2022.2074711","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>There is a growing number of patients with ventricular paced rhythm, who present to the emergency department with chest pain. The diagnosis of ST-segment elevation myocardial infarction (STEMI) and subsequent percutaneous coronary intervention (PCI) is often postponed, as the 12 leads-electrocardiogram (ECG) is discarded as not interpretable. There is a growing body of literature that suggests that Smith-modified Sgarbossa criteria can be applied for the diagnosis of STEMI in patients with paced rhythms. These criteria were originally developed for the interpretation of ECGs in patients with a left bundle branch block (LBBB) and chest pain, but have been expanded to paced ECGs.</p><p><strong>Methodology: </strong>We present three case reports with chest pain and right ventricular or biventricular pacing.</p><p><strong>Findings: </strong>In all three cases, the Smith-modified Sgarbossa was positive and the diagnosis of STEMI could have been made early on.</p><p><strong>Implications: </strong>It remains important to look for ST-segment deviations and to compare the symptomatic ECG with previous asymptomatic ECGs. As the number of patients with potential acute myocardial infarction (AMI) and paced rhythms is likely to rise in the future, these criteria should be known to emergency physicians and cardiologists.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":"78 2","pages":"165-170"},"PeriodicalIF":1.6000,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"AMI in (bi)ventricular pacing - do not discard the ECG.\",\"authors\":\"T Versyck, D Devriese, S Smith, P Calle, C Borin\",\"doi\":\"10.1080/17843286.2022.2074711\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>There is a growing number of patients with ventricular paced rhythm, who present to the emergency department with chest pain. The diagnosis of ST-segment elevation myocardial infarction (STEMI) and subsequent percutaneous coronary intervention (PCI) is often postponed, as the 12 leads-electrocardiogram (ECG) is discarded as not interpretable. There is a growing body of literature that suggests that Smith-modified Sgarbossa criteria can be applied for the diagnosis of STEMI in patients with paced rhythms. These criteria were originally developed for the interpretation of ECGs in patients with a left bundle branch block (LBBB) and chest pain, but have been expanded to paced ECGs.</p><p><strong>Methodology: </strong>We present three case reports with chest pain and right ventricular or biventricular pacing.</p><p><strong>Findings: </strong>In all three cases, the Smith-modified Sgarbossa was positive and the diagnosis of STEMI could have been made early on.</p><p><strong>Implications: </strong>It remains important to look for ST-segment deviations and to compare the symptomatic ECG with previous asymptomatic ECGs. As the number of patients with potential acute myocardial infarction (AMI) and paced rhythms is likely to rise in the future, these criteria should be known to emergency physicians and cardiologists.</p>\",\"PeriodicalId\":7086,\"journal\":{\"name\":\"Acta Clinica Belgica\",\"volume\":\"78 2\",\"pages\":\"165-170\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2023-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acta Clinica Belgica\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/17843286.2022.2074711\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Clinica Belgica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/17843286.2022.2074711","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
AMI in (bi)ventricular pacing - do not discard the ECG.
Background: There is a growing number of patients with ventricular paced rhythm, who present to the emergency department with chest pain. The diagnosis of ST-segment elevation myocardial infarction (STEMI) and subsequent percutaneous coronary intervention (PCI) is often postponed, as the 12 leads-electrocardiogram (ECG) is discarded as not interpretable. There is a growing body of literature that suggests that Smith-modified Sgarbossa criteria can be applied for the diagnosis of STEMI in patients with paced rhythms. These criteria were originally developed for the interpretation of ECGs in patients with a left bundle branch block (LBBB) and chest pain, but have been expanded to paced ECGs.
Methodology: We present three case reports with chest pain and right ventricular or biventricular pacing.
Findings: In all three cases, the Smith-modified Sgarbossa was positive and the diagnosis of STEMI could have been made early on.
Implications: It remains important to look for ST-segment deviations and to compare the symptomatic ECG with previous asymptomatic ECGs. As the number of patients with potential acute myocardial infarction (AMI) and paced rhythms is likely to rise in the future, these criteria should be known to emergency physicians and cardiologists.
期刊介绍:
Acta Clinica Belgica: International Journal of Clinical and Laboratory Medicine primarily publishes papers on clinical medicine, clinical chemistry, pathology and molecular biology, provided they describe results which contribute to our understanding of clinical problems or describe new methods applicable to clinical investigation. Readership includes physicians, pathologists, pharmacists and physicians working in non-academic and academic hospitals, practicing internal medicine and its subspecialties.