open access

Vol 13, No 7 (2006): Folia Cardiologica
Original articles
Published online: 2006-09-15
Submitted: 2013-01-14
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The value of the initial electrocardiogram in the evaluation of an acutely ischaemic area in anterior myocardial infarction

Małgorzata Czechowska, Zdzisława Kornacewicz-Jach, Jarosław Gorący, Krzysztof Przybycień, Joanna Zielonka, Maciej Lewandowski, Andrzej Wojtarowicz, Irmina Kossuth
Folia Cardiol 2006;13(7):570-577.

open access

Vol 13, No 7 (2006): Folia Cardiologica
Original articles
Published online: 2006-09-15
Submitted: 2013-01-14

Abstract

Background: The aim of the study was to evaluate the importance of admission electrocardiography (ECG) in predicting the extent of acute ischaemia in anterior acute myocardial infarction (AMI).
Methods: In 56 patients with anterior AMI electrocardiographic, echocardiographic and angiographic images, troponin I concentration and CK-MB activity were analysed.
Results: In 55 cases the artery responsible for infarction was the left anterior descendent (LAD). In the group with proximal occlusions the number of leads with ST elevation was greater (6.6 ± 1.4 vs. 5.3 ± 1.8; p = 0.02) and the level of ST elevations in all leads was higher (18.3 ± 9.9 vs. 11.6 ± 7.2; p = 0.01). The mean height of ST elevation in I, aVL, V3 and V5, ST-segment depression in inferior leads and CK-MB activity, was higher in proximal LAD disease. The height of ST elevation in I and aVL correlated with a low ejection fraction and high CK-MB activity. The higher the total ST-segment elevation in all leads, the higher CK-MB activity level.
Conclusions: ECG is useful in identifying the site of a LAD occlusion in an anterior AMI. The total ST-segment elevation correlates with the AMI size measured as the maximal CK-MB activity. The height of the ST-segment elevation in leads I and aVL reflects the degree of left ventricle dysfunction. The traditional terminology used to define the localisation of ST-segment shifts in ECG does not take account of the regional wall motion abnormalities observed in echocardiographic examination in an anterior AMI.

Abstract

Background: The aim of the study was to evaluate the importance of admission electrocardiography (ECG) in predicting the extent of acute ischaemia in anterior acute myocardial infarction (AMI).
Methods: In 56 patients with anterior AMI electrocardiographic, echocardiographic and angiographic images, troponin I concentration and CK-MB activity were analysed.
Results: In 55 cases the artery responsible for infarction was the left anterior descendent (LAD). In the group with proximal occlusions the number of leads with ST elevation was greater (6.6 ± 1.4 vs. 5.3 ± 1.8; p = 0.02) and the level of ST elevations in all leads was higher (18.3 ± 9.9 vs. 11.6 ± 7.2; p = 0.01). The mean height of ST elevation in I, aVL, V3 and V5, ST-segment depression in inferior leads and CK-MB activity, was higher in proximal LAD disease. The height of ST elevation in I and aVL correlated with a low ejection fraction and high CK-MB activity. The higher the total ST-segment elevation in all leads, the higher CK-MB activity level.
Conclusions: ECG is useful in identifying the site of a LAD occlusion in an anterior AMI. The total ST-segment elevation correlates with the AMI size measured as the maximal CK-MB activity. The height of the ST-segment elevation in leads I and aVL reflects the degree of left ventricle dysfunction. The traditional terminology used to define the localisation of ST-segment shifts in ECG does not take account of the regional wall motion abnormalities observed in echocardiographic examination in an anterior AMI.
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Keywords

electrocardiogram; anterior myocardial infarction; ST-segment elevation; biochemical markers of myocardial necrosis

About this article
Title

The value of the initial electrocardiogram in the evaluation of an acutely ischaemic area in anterior myocardial infarction

Journal

Cardiology Journal

Issue

Vol 13, No 7 (2006): Folia Cardiologica

Pages

570-577

Published online

2006-09-15

Bibliographic record

Folia Cardiol 2006;13(7):570-577.

Keywords

electrocardiogram
anterior myocardial infarction
ST-segment elevation
biochemical markers of myocardial necrosis

Authors

Małgorzata Czechowska
Zdzisława Kornacewicz-Jach
Jarosław Gorący
Krzysztof Przybycień
Joanna Zielonka
Maciej Lewandowski
Andrzej Wojtarowicz
Irmina Kossuth

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