Electrocardiography in myocardial infarction diagnosis: a view through the prism of guidelines (Lecture)

Electrocardiography (ECG) is considered as an essential step in acute coronary syndrome (ACS) diagnostic algorithm. Сurrent classification is based on the ECG changes of ST-segment and includes ACS with persistent ST elevation and without persistent ST elevation. ACS with persistent ST elevation is characterized by prolonged (more than 20 min) ST-segment elevation exceeding 0.1 mV in two or more contiguous ECG leads (except V2–3 as well as aVR). When the symptoms of acute myocardial ischemia are present, ECG should be recorded within 10 minutes from the first contact with a medical professional. Some changes on the initial ECG of a patient with ACS may be nonspecific or absent, so the key role in diagnosis is given to the clinical presentation and the ECG in dynamics.