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Card Electrophysiol Rev. 2002 Sep;6(3):196-203.

Electrocardiographic ST-segment changes during acute myocardial ischemia.

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Dalhousie University, Halifax, Nova Scotia, Canada.


The recognition and management of patients with acute coronary syndromes has relied to a large extent on the standard 12-lead electrocardiogram (ECG) for assessing ST-segment changes associated with ischemia. The purpose of this review is to show both the capabilities and the limitations of the 12-lead ECG in recognizing ischemia, and to seek alternative electrocardiographic leads, optimized for detection of ischemia originating in different regions of the ventricular myocardium. Three such leads are proposed-based on the results obtained by electrocardiographic body-surface mapping performed during ischemia induced by balloon-inflation coronary angioplasty. A survey of recent clinical studies shows that the electrocardiographic manifestations of acute myocardial ischemia observed during coronary angioplasty are in agreement with the ST-segment measurements in admission ECGs of patients with acute myocardial infarction.

[Indexed for MEDLINE]

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