Recognizing electrocardiographically subtle occlusion myocardial infarction and differentiating it from mimics: Ten steps to or away from cath lab

Aslanger E. K., Meyers H. P., Smith S. W.

TURK KARDIYOLOJI DERNEGI ARSIVI-ARCHIVES OF THE TURKISH SOCIETY OF CARDIOLOGY, cilt.49, sa.6, ss.488-500, 2021 (ESCI) identifier identifier identifier

  • Yayın Türü: Makale / Derleme
  • Cilt numarası: 49 Sayı: 6
  • Basım Tarihi: 2021
  • Doi Numarası: 10.5543/tkda.2021.21026
  • Dergi Adı: TURK KARDIYOLOJI DERNEGI ARSIVI-ARCHIVES OF THE TURKISH SOCIETY OF CARDIOLOGY
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, Central & Eastern European Academic Source (CEEAS), EMBASE, MEDLINE, Directory of Open Access Journals, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.488-500
  • Anahtar Kelimeler: Acute coronary syndrome, coronary occlusion, electrocardiography, myocardial infarction, percutaneous coronary interventions, ST-SEGMENT ELEVATION, BUNDLE-BRANCH BLOCK, EARLY REPOLARIZATION, UNIVERSAL DEFINITION, DIAGNOSIS, PATTERN, PATIENT, QRS, ARTERY, COMMON
  • Marmara Üniversitesi Adresli: Evet

Özet

It is increasingly evident that the ST-segment elevation (STE) myocardial infarction (MI)/non-STEMI paradigm that equates STEM I with acute coronary occlusion (ACO) is deceptive. This unfortunate paradigm, adhered to by the current guidelines, misses at least one-fourth of the ACOs, and unnecessarily over-triages a similar fraction of the patients to the catheterization laboratory. Accordingly, we have been calling for a new paradigm, the occlusion/nonocclusion MI (OMI/NOMI). Although this new OMI/NOMI paradigm is not limited to an electrocardiogram (ECG), the ECG will remain the cornerstone of this new paradigm because of its speed, repeatability, noninvasive nature, wide availability, and high diagnostic power for OMI. This review provides a step-by-step approach to ECG for the diagnosis of OMI.