Dilated cardiomyopathy, are a few drinks allowed?

inhibitor to reduced dose thrombolytic therapy significantly improved myocardial perfusion as assessed by ST segment resolution. Thus, this simple tool (that all clinicians can use by simply obtaining a 12-lead ECG 90 min after the start of thrombolysis — and comparing it to the baseline ECG), allows determination of several key aspects of response to therapy and assessment of prognosis. The second area of importance of the ST segments is in assessing prognosis. This is true for patients with ST elevation myocardial infarction (with either the baseline ECG, or as noted above, using the change from baseline to 90 or 180 min), and for those with non-ST elevation acute coronary syndromes. In the latter case, presence of just 0·5 mm ST segment depression has been found to confer as bad prognostic significance as the more traditional 1 mm ST depression. It should be noted that for ST elevation myocardial infarction, the significance of 0·5 mm ST elevation has not been evaluated. For me, the take home message is: Pay close attention to the ST segments! They are helpful in (1) the initial diagnosis of myocardial infarction, (2) evaluating the response to therapy, and (3) predicting future prognosis. If we carefully scrutinize the 12-lead electrocardiogram, it should assist us in targeting appropriate therapies for the broad group of patients with acute myocardial infarction and acute coronary syndromes. C. P. CANNON Brigham and Women’s Hospital, Boston, MA, U.S.A.