Praecordial ECG Mapping in Acute Anterior Myocardial Infarction: The Evolution of ST Segment and Q and R Waves

K. Thygesen*, M. Hørder, P. Hyltoft Petersen, B. Lyager Nielsen

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Resumé

ABSTRACT. Praecordial ECG mapping (42 leads) was carried out in 16 patients with anterior myocardial infarction, admitted up to 3 hours after the onset of symptoms. The mappings were performed according to a set time schedule throughout the acute phase and one year after the infarction. For each ECG map the number of leads with ST elevation ≥ 1.5 mm (NST) and the sum of these (σST) were calculated. In addition, the sum of Q amplitudes (σQ) and R amplitudes (σR) were determined. On average, the initial σST elevation decreased from 2 to 8 hours. A secondary increase, occurring in 14 patients, was maximal during days 2–5. Based on the appearance function of creatine kinase in plasma and the QRS alterations, it is suggested that this re‐elevation of the ST segment was due to infarct extension (5 pats.) or expansion (9 pats.). The course of the average NST was similar to σST. σQ began to develop at 3 hours, the maximum deflection being reached after about 24 hours (range 8–45). σR was falling at 2 hours; the maximum rate of decrease occurred, on average, within the first 24 hours (range 12–54). One year after the infarction, both σQ and σR had the same level as at 8 hours. The ST elevation at 4 hours was related to the development of Q and R waves within 24 hours, but only a weak or no correlation was found. Thus, there was very little value in predicting the development of QR changes from the ST elevation at 4 hours. 1981 Association for the Publication of the Journal of Internal Medicine

OriginalsprogEngelsk
TidsskriftActa Medica Scandinavica
Vol/bind209
Udgave nummer1-6
Sider (fra-til)161-167
Antal sider7
ISSN0001-6101
DOI
StatusUdgivet - 1. jan. 1981

Fingeraftryk

Infarction
Electrocardiography
Accidental Falls
Internal Medicine
Publications

Citer dette

Thygesen, K. ; Hørder, M. ; Petersen, P. Hyltoft ; Nielsen, B. Lyager. / Praecordial ECG Mapping in Acute Anterior Myocardial Infarction : The Evolution of ST Segment and Q and R Waves. I: Acta Medica Scandinavica. 1981 ; Bind 209, Nr. 1-6. s. 161-167.
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abstract = "ABSTRACT. Praecordial ECG mapping (42 leads) was carried out in 16 patients with anterior myocardial infarction, admitted up to 3 hours after the onset of symptoms. The mappings were performed according to a set time schedule throughout the acute phase and one year after the infarction. For each ECG map the number of leads with ST elevation ≥ 1.5 mm (NST) and the sum of these (σST) were calculated. In addition, the sum of Q amplitudes (σQ) and R amplitudes (σR) were determined. On average, the initial σST elevation decreased from 2 to 8 hours. A secondary increase, occurring in 14 patients, was maximal during days 2–5. Based on the appearance function of creatine kinase in plasma and the QRS alterations, it is suggested that this re‐elevation of the ST segment was due to infarct extension (5 pats.) or expansion (9 pats.). The course of the average NST was similar to σST. σQ began to develop at 3 hours, the maximum deflection being reached after about 24 hours (range 8–45). σR was falling at 2 hours; the maximum rate of decrease occurred, on average, within the first 24 hours (range 12–54). One year after the infarction, both σQ and σR had the same level as at 8 hours. The ST elevation at 4 hours was related to the development of Q and R waves within 24 hours, but only a weak or no correlation was found. Thus, there was very little value in predicting the development of QR changes from the ST elevation at 4 hours. 1981 Association for the Publication of the Journal of Internal Medicine",
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Praecordial ECG Mapping in Acute Anterior Myocardial Infarction : The Evolution of ST Segment and Q and R Waves. / Thygesen, K.; Hørder, M.; Petersen, P. Hyltoft; Nielsen, B. Lyager.

I: Acta Medica Scandinavica, Bind 209, Nr. 1-6, 01.01.1981, s. 161-167.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Praecordial ECG Mapping in Acute Anterior Myocardial Infarction

T2 - The Evolution of ST Segment and Q and R Waves

AU - Thygesen, K.

AU - Hørder, M.

AU - Petersen, P. Hyltoft

AU - Nielsen, B. Lyager

PY - 1981/1/1

Y1 - 1981/1/1

N2 - ABSTRACT. Praecordial ECG mapping (42 leads) was carried out in 16 patients with anterior myocardial infarction, admitted up to 3 hours after the onset of symptoms. The mappings were performed according to a set time schedule throughout the acute phase and one year after the infarction. For each ECG map the number of leads with ST elevation ≥ 1.5 mm (NST) and the sum of these (σST) were calculated. In addition, the sum of Q amplitudes (σQ) and R amplitudes (σR) were determined. On average, the initial σST elevation decreased from 2 to 8 hours. A secondary increase, occurring in 14 patients, was maximal during days 2–5. Based on the appearance function of creatine kinase in plasma and the QRS alterations, it is suggested that this re‐elevation of the ST segment was due to infarct extension (5 pats.) or expansion (9 pats.). The course of the average NST was similar to σST. σQ began to develop at 3 hours, the maximum deflection being reached after about 24 hours (range 8–45). σR was falling at 2 hours; the maximum rate of decrease occurred, on average, within the first 24 hours (range 12–54). One year after the infarction, both σQ and σR had the same level as at 8 hours. The ST elevation at 4 hours was related to the development of Q and R waves within 24 hours, but only a weak or no correlation was found. Thus, there was very little value in predicting the development of QR changes from the ST elevation at 4 hours. 1981 Association for the Publication of the Journal of Internal Medicine

AB - ABSTRACT. Praecordial ECG mapping (42 leads) was carried out in 16 patients with anterior myocardial infarction, admitted up to 3 hours after the onset of symptoms. The mappings were performed according to a set time schedule throughout the acute phase and one year after the infarction. For each ECG map the number of leads with ST elevation ≥ 1.5 mm (NST) and the sum of these (σST) were calculated. In addition, the sum of Q amplitudes (σQ) and R amplitudes (σR) were determined. On average, the initial σST elevation decreased from 2 to 8 hours. A secondary increase, occurring in 14 patients, was maximal during days 2–5. Based on the appearance function of creatine kinase in plasma and the QRS alterations, it is suggested that this re‐elevation of the ST segment was due to infarct extension (5 pats.) or expansion (9 pats.). The course of the average NST was similar to σST. σQ began to develop at 3 hours, the maximum deflection being reached after about 24 hours (range 8–45). σR was falling at 2 hours; the maximum rate of decrease occurred, on average, within the first 24 hours (range 12–54). One year after the infarction, both σQ and σR had the same level as at 8 hours. The ST elevation at 4 hours was related to the development of Q and R waves within 24 hours, but only a weak or no correlation was found. Thus, there was very little value in predicting the development of QR changes from the ST elevation at 4 hours. 1981 Association for the Publication of the Journal of Internal Medicine

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KW - CK plasma appearance

KW - heart failure

KW - infarct extension/expansion

KW - primary/secondary ST elevation

KW - Q/R amplitude

KW - transmural infarction

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JO - Journal of Internal Medicine. Supplement

JF - Journal of Internal Medicine. Supplement

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