Diagnostic Precision of the Electrocardiogram for Detection of Culprit Lesion of Infarct Related Artery in Acute ST Elevation Myocardial Infarction
Message:
Abstract:
Background And Aim
Despite impressive advances in diagnosis over the past decades, ST elevation myocardial infarction (STEMI) continues to be a major public health problem in the many countries. In majority of patients with some STEMI, changes can be documented when serial electrocardiography (ECG) are compared; however, many factors limit the ability of ECG to diagnose and localize myocardial infarction (MI). The aim of this study was to evaluate accuracy of ECG in diagnosis and localization of MI.
Materials And Methods
This prospective study was conducted on patients with STEMI who were admitted in Modarress Hospital, in Tehran. All patients underwent electrocardiography and angiography. Then, findings of these two noninvasive and invasive diagnostic methods were described with two independent operators.
Results
140 STEMI patients (80 patients with anterior and 60 patients with inferior MI) were enrolled in this study. Presence of complete right bundle branch block (CRBB) in ECG of patients with anterior MI had the least negative predictive value (NPV=69%). ST segment depression more than 1mm in lead d1 had the most positive predictive value (ppb=97%) for right coronary artery involvement. ST segment elevation in leads v5 & v6 had the least positive value (ppv= 81%) for LCX involvement. ST segment depression in inferior leads had the most negative predictive value (94%) for LAD involvement.
Conclusion
In patents with STEMI, electrocardiography alone is not a good diagnostic method to diagnose and localize MI
Language:
Persian
Published:
Researcher Bulletin of Medical Sciences, Volume:14 Issue: 5, 2009
Page:
269
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