ECG diagnosis: ST-elevation myocardial infarction.
نویسندگان
چکیده
Calvin Hwang, MD, is an Emergency Medicine Resident in the Stanford/Kaiser Emergency Medicine Residency Program in CA. E-mail: [email protected]. Joel T Levis, MD, PhD, FACEP, FAAEM, is a Senior Emergency Medicine Physician at the Santa Clara Medical Center, and Clinical Assistant Professor of Emergency Medicine (Surgery) at Stanford University. He is the Medical Director for the Foothill College Paramedic Program in Los Altos, CA. E-mail: [email protected]. ST-elevation myocardial infarction (STEMI) is a clinical syndrome defined by characteristic symptoms of myocardial ischemia in association with persistent electrocardiographic ST elevation (STE) and subsequent release of biomarkers of myocardial necrosis. STE is the single best immediately available surrogate marker for detecting acute complete coronary artery occlusion without collateral circulation, signifying a significant region of injured myocardium at imminent risk of irreversible infarction, requiring immediate reperfusion therapy. Diagnostic STE is defined as new STE at the J point in at least 2 contiguous leads > 2 mm (0.2 mV) in men or > 1.5 mm (0.15 mV) in women in leads V2-V3 and/or of > 1 mm (0.1 mV) in other contiguous chest or limb leads. The presence of reciprocal changes (manifested as ST depression in a region that approximates the vector 180 degrees opposite the major vessel of injury) increases the specificity of STE caused by STEMI. New or presumably new left bundle branch block has been considered a STEMI equivalent. Reperfusion therapy should be administered to all eligible patients with STEMI who have experienced symptom onset within the previous 12 hours. Primary percutaneous coronary intervention is the recommended method of reperfusion when it can be performed in a timely fashion by experienced operators, with a goal of first medical contact-toballoon time of 90 minutes or less. v
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ورودعنوان ژورنال:
- The Permanente journal
دوره 18 2 شماره
صفحات -
تاریخ انتشار 2014