QRS mapping in the evaluation of acute anterior myocardial infarction.
- 1 August 1980
- journal article
- abstracts
- Published by Wolters Kluwer Health in Circulation
- Vol. 62 (2), 266-276
- https://doi.org/10.1161/01.cir.62.2.266
Abstract
In 42 patients with acute anterior myocardial infarction (AMI), we studied the course of Q-wave development and R-wave reduction during the first 48 hours after the onset of chest pain. We used precordial mapping in relation to clinical features, hemodynamic measurements and enzyme release. Q waves developed within 6-14 hours (mean 9 hours) after onset of symptoms. R-wave amplitudes demonstrated nearly a reflected image: They reduced abruptly 5-11 hours (mean 9 hours) after onset of chest pain, coinciding with ST-segment elevation. In 14 patients (group A, 33%) after initial QRS alterations, there were no further changes. Twenty patients (group B, 48%) had a distinct new increase of Q waves (delta sigma Q = 3.0 +/- 2.0 mV/hours) and further R-wave reduction (-delta sigma R = 1.0 +/- 0.6 mV/hour) simultaneous with new severe chest pain and a delayed second increase of enzyme release corresponding with extension of infarction. There were no significant differences between the groups in age, hemodynamics and infarct size calculated from creatine kinase release. Eight patients (group C, 19%) had contradictory findings. Our findings are consistent with previous results indicating that the critical period for intervention is very small except in patients with extension of necrosis.Keywords
This publication has 33 references indexed in Scilit:
- Spontaneous course of ST-segment elevation in acute anterior myocardial infarction.Circulation, 1979
- Nitroglycerin Infusion in Acute Myocardial InfarctionNew England Journal of Medicine, 1977
- Favorable Effects of Hyaluronidase on Electrocardiographic Evidence of Necrosis in Patients with Acute Myocardial InfarctionNew England Journal of Medicine, 1977
- Precordial Mapping in Acute Myocardial InfarctionJapanese Heart Journal, 1977
- Thermodilution cardiac output determination with a single flow-directed catheterAmerican Heart Journal, 1972
- Transient QRS changes simulating myocardial infarction associated with shock and severe metabolic stressAmerican Heart Journal, 1967
- VII. Correlation of electrocardiographic and pathologic findings in lateral infarctionAmerican Heart Journal, 1949
- II. Correlation of electrocardiographic and pathologic findings in large anterolateral infarctsAmerican Heart Journal, 1948
- I. Correlation of electrocardiographic and pathologic findings in anteroseptal infarctionAmerican Heart Journal, 1948
- Changes in the precordial electrocardiogram produced by extension of anteroseptal myocardial infarctionAmerican Heart Journal, 1945