Medicine of the Future in America

Initial Electrocardiogram in Patients with Suspected Ischemic Chest Pain (5)

Initial Electrocardiogram in Patients with Suspected Ischemic Chest Pain (5)Second, the initial ECG plays an important role in coronary thrombolysis. An abnormal ECG is one of the criteria for thrombolytic therapy and helps to identify patients who will or will not benefit from coronary reperfusion. According to Bar et al, patients who benefited most from coronary thrombolysis were those with prominent ST segment elevation. In contrast, in patients with ST segment depression or previous myocardial infarction, coronary thrombolysis did not improve mortality. However, this finding has not been confirmed by some newer studies; ie, coronary thrombolysis improved mortality regardless of the ECG. It is possible that in the future, the ECG will play a less important role in candidates for coronary thrombolysis. buy flovent inhaler
Third, there is a difference between patients with NQMI who have ST segment elevation or depression. Willich et al and others showed that patients with ST segment elevation have a better prognosis than those with ST segment depression. The former group has less severe coronary artery disease and better left ventricular function despite a similar or smaller enzymatic infarct size.
Fourth, in patients with isolated T wave changes, the short-term outcome is more favorable than in patients with ST segment depression.

This entry was posted in Ischemic Chest Pain and tagged coronary artery, depression, myocardial infarction, unstable angina.
Copyright © 2012 Medicine of the Future in America www.perfexis.org