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Cardiol Clin. 2006 Aug;24(3):387-99, ix.

Electrocardiographic diagnosis of myocardial infarction and ischemia during cardiac pacing.

Author information

1
Division of Cardiology, University of South Florida College of Medicine and Tampa General Hospital, Tampa, FL, USA. ssbarold@aol.com

Abstract

For the diagnosis of myocardial infarction (MI) using the QRS complex, the ECG provides only a low sensitivity (25%) but high specificity (close to 100%), but one cannot determine the age of an MI from the QRS complex. Although one cannot determine with certainty the age of an MI (hours, days or even years) from a single ECG, the presence of primary ST-segment abnormalities strongly suggests the diagnosis of acute MI or severe ischemia and the possible need for emergency revascularization. For acute MI, ST elevation>or=5 mm in predominantly negative QRS complexes is the best marker with a sensitivity of 53%, and specificity of 88%. A recent investigation suggests that T wave abnormalities from ischemia can be differentiated from those caused by cardiac memory related to pacing.

PMID:
16939831
DOI:
10.1016/j.ccl.2006.05.003
[Indexed for MEDLINE]

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