American Journal of Cardiology
Volume 103, Issue 3 , Pages 301-306 , 1 February 2009

Differentiating ST Elevation Myocardial Infarction and Nonischemic Causes of ST Elevation by Analyzing the Presenting Electrocardiogram

  • Jason B. Jayroe, MD

      Affiliations

    • University of Texas Medical Branch, Galveston, Texas
    • ,
  • David H. Spodick, MD

      Affiliations

    • University of Massachusetts Medical School, Worcester, Massachusetts
    • ,
  • Kjell Nikus, MD

      Affiliations

    • Heart Center, Tampere, Finland
    • ,
  • John Madias, MD, FACC

      Affiliations

    • Mount Sinai School of Medicine, Elmhurst, New York
    • ,
  • Miguel Fiol, MD

      Affiliations

    • Hospital Son Dureta, Palma de Mallorca, Spain
    • ,
  • Antoni Bayés De Luna, MD, PhD

      Affiliations

    • Inst Català Ciències Cardiovasculars, Barcelona, Spain
    • ,
  • Diego Goldwasser, MD

      Affiliations

    • Inst Català Ciències Cardiovasculars, Barcelona, Spain
    • ,
  • Peter Clemmensen, MD

      Affiliations

    • Copenhagen University Hospital, Copenhagen, Denmark
    • ,
  • Yuling Fu, MD

      Affiliations

    • University of Alberta, Edmonton, AB, Canada
    • ,
  • Anton P. Gorgels, MD, PhD

      Affiliations

    • University Hospital Maastricht, Maastricht, The Netherlands
    • ,
  • Samuel Sclarovsky, MD

      Affiliations

    • Sackler School of Medicine, Tel Aviv, Israel
    • ,
  • Paul D. Kligfield, MD

      Affiliations

    • Weill Cornell Medical College, New York, New York
    • ,
  • Galen S. Wagner, MD

      Affiliations

    • Duke University Medical Center, Durham, North Carolina
    • ,
  • Charles Maynard, PhD

      Affiliations

    • University of Washington, Seattle, Washington
    • ,
  • Yochai Birnbaum, MD

      Affiliations

    • University of Texas Medical Branch, Galveston, Texas
    • Corresponding Author InformationCorresponding author: Tel: 713-798-0283; fax: 713-798-0270

Received 28 August 2008 ,Revised 23 September 2008 ,Accepted 23 September 2008.

References 

  1. Antman EM, Anbe DT, Armstrong PW, Bates ER, Green LA, Hand M, et al ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction—Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction). J Am Coll Cardiol. 2004;44:671–719
  2. Otto LA, Aufderheide TP. Evaluation of ST segment elevation criteria for the prehospital electrocardiographic diagnosis of acute myocardial infarction. Ann Emerg Med. 1994;23:17–24
  3. Brady WJ, Perron AD, Martin ML, Beagle C, Aufderheide TP. Cause of ST Segment Abnormality in ED chest pain patients. Am J Emerg Med. 2001;19:25–28
  4. Brady WJ, Syverud SA, Beagle C, Perron AD, Ullman EA, Holstege C, et al. Electrocardiographic ST segment elevation: The diagnosis of acute myocardial infarction by morphologic analysis of the ST segment. Acad Emerg Med. 2001;8:961–967
  5. Brady WJ, Perron AD, Chan T. Electrocardiographic ST-segment elevation: correct identification of acute myocardial infarction (AMI) and non-AMI syndromes by emergency physicians. Acad Emerg Med. 2001;8:349–360
  6. Wang K, Asinger RW, Marriott HJL. ST-segment elevation in conditions other than acute myocardial infarction. N Engl J Med. 2003;349:2128–2135
  7. Canto JG, Shlipak MG, Rogers WJ, Malmgren JA, Frederick PD, Lambrew CT, et al. Prevalence, clinical characteristics, and mortality among patients with myocardial infarction presenting without chest pain. JAMA. 2000;283:3223–3229
  8. Deedwania PC, Carbajal EV. Silent myocardial ischemia—a clinical perspective. Arch Intern Med. 1991;151:2373–2382
  9. Kyker KA, Limacher MC. Gender differences in presentation and symptoms of coronary artery disease. Curr Womens Health Rep. 2002;2:115–119
  10. Atar S, Birnbaum Y. Ischemia-induced ST-segment elevation: classification, prognosis, and therapy. J Electrocardiol. 2005;38(4 Suppl):1–7
  11. Larson DM, Menssen KM, Sharkey SW, Duval S, Schwartz RS, Harris J, et al. “False-positive” cardiac catheterization laboratory activation among patients with suspected ST-segment elevation myocardial infarction. JAMA. 2007;298:2754–2760
  12. Sejersten M, Sillesen M, Hansen PR, Nielsen SL, Nielsen H, Trautner S, et al. Effect on treatment delay of prehospital teletransmission of 12-lead electrocardiogram to a cardiologist for immediate triage and direct referral of patients with ST-segment elevation acute myocardial infarction to primary percutaneous coronary intervention. Am J Cardiol. 2008;101:941–946

PII: S0002-9149(08)01677-9

doi: 10.1016/j.amjcard.2008.09.082

American Journal of Cardiology
Volume 103, Issue 3 , Pages 301-306 , 1 February 2009

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