[Electrocardiography in the diagnostics of acute myocardial infarction with ST elevation].
After a century of clinical use, electrocardiography (ECG) remains the basic method for the diagnosis of acute myocardial infarction. Its suboptimal sensitivity can be improved by additional recording leads and device adjustment with posterior wall inverse presentation for the detection of left ventricular posterior wall and right ventricle infarcts. The addition of some ST-depression criteria equivalent to those of ST elevation is discussed, with the aim of increasing the sensitivity without a substantial loss of specificity. ECG patterns concerning myocardial infarction evolution, localization and size estimates are reviewed. PIS and EMI patterns are discussed in respect to the modes of reperfusion therapy. ECG scoring systems are commented, considering risk stratification and the choice of reperfusion therapy. In conclusion, ECG is an old diagnostic tool that should be used for new tasks.
Smalcelj
Anton
A
University Department of Cardiovascular Diseases, Zagreb University Hospital Center and School of Medicine, University of Zagreb, Zagreb, Croatia.
D004562:Electrocardiography; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology; D012680:Sensitivity and Specificity