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E-raamat: ECG in Acute Myocardial Infarction and Unstable Angina: Diagnosis and Risk Stratification

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This work demonstrates the use of the electrocardiogram (ECG) in evaluating patients presenting with symptoms suggestive of acute myocardial ischemia. Chapters cover determining the size of the area at risk and identifying the site of occlusion in the culprit coronary artery, conduction disturbances in acute myocardial infarction, myocardial infarction in the presence of abnormal ventricular activation, arrhythmias in acute myocardial infarction, and the ECG in unstable angina. Wellens teaches cardiology at Academic Hospital Maastricht, The Netherlands. Annotation (c) Book News, Inc., Portland, OR (booknews.com)

Every time a patient presents with acute chest pain, the challenge is to make, as soon as possible, the correct diagnosis of presence, size, site and severity of myocardial ischemia. The electrocardiogram is the only tool able to do so immediately, in a non-invasive way and at low cost. Recently, new information has become available allowing us to recognize where in the coronary artery the culprit lesion is located and thereby estimate the size of the area of the heart which is jeopardized. This is of obvious importance in determining the aggressiveness of our therapy. Will we select a thrombus dissolving drug or opt for an invasive coronary intervention? In myocardial ischemia rhythm and conduction disturbances are often present. Again, proper ECG interpretation under these circumstances is essential for management of the patient and future risk assessment. When reperfusion of the acutely ischemic area is attempted by thrombolytic therapy or a percutaneous coronary intervention the ECG is important to inform us about the result. Not only in acute myocardial infarction but also in unstable angina the size, site and severity of cardiac ischemia is of great importance. Again that information can be provided by the electrocardiogram. All this new information is thoroughly discussed by members of the internationally recognized Maastricht school of electrocardiography. The book is a must for any healthcare professional engaged in the management of the patient with acute chest pain.
Introduction
1(4)
Determining the size of the area at risk, the severity of ischemia, and identifying the site of occlusion in the culprit coronary artery
5(38)
The ST segment deviation score
9(2)
The terminal QRS-ST segment pattern
11(2)
Specific ECG patterns indicating the site of coronary artery occlusion:
13(30)
Infero-posterior myocardial infarction with or without right ventricular infarction
13(11)
Anterior wall myocardial infarction
24(19)
Conduction disturbances in acute myocardial infarction
43(22)
The sino-atrial region
45(4)
The AV nodal conduction system
49(4)
The sub-AV nodal conduction system
53(12)
Myocardial infarction in the presence of abnormal ventricular activation
65(20)
Left bundle branch block
68(8)
Paced ventricular rhythm
76(3)
Pre-excitation
79(6)
Arrhythmias in acute myocardial infarction: Incidence and prognostic significance
85(14)
Supraventricular arrhythmias
87(4)
Ventricular arrhythmias
91(8)
The electrocardiographic signs of reperfusion
99(18)
The electrocardiogram in unstable angina
117(10)
Recognition of multivessel and left main disease
Recognition of critical narrowing of the left anterior descending coronary artery
Index 127