American Journal of Cardiology
Volume 104, Issue 2 , Pages 190-193 , 15 July 2009

Utility of the Frontal Plane QRS Axis in Identifying Non–ST-Elevation Myocardial Infarction in Patients With Poor R-Wave Progression

  • Laxman Prajapat, MD

      Affiliations

    • Department of Medicine, St. Vincent Hospital, University of Massachusetts, Worcester, Massachusetts
    • ,
  • Vignendra Ariyarajah, MD

      Affiliations

    • Division of Cardiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
    • Corresponding Author InformationCorresponding author: Tel: (267) 694-7608; fax: (215) 923-4942
    • ,
  • David H. Spodick, MD

      Affiliations

    • Department of Medicine, St. Vincent Hospital, University of Massachusetts, Worcester, Massachusetts
    • Division of Cardiology, Department of Medicine, St. Vincent Hospital, University of Massachusetts, Worcester, Massachusetts

Received 11 January 2009 ,Revised 3 March 2009 ,Accepted 3 March 2009.

References 

  1. Gunnar RM, Pietras RJ, Blackaller J, Dadmun SE, Szanto PB, Tobin JR. Correlation of vectorcardiographic criteria for myocardial infarction with autopsy findings. Circulation. 1967;35:158–171
  2. Zema MJ, Kligfield P. Electrocardiographic poor R wave progression (I: correlation with the frank vectorcardiogram). J Electrocardiol. 1979;12:3–10
  3. DePace NL, Colby J, Hakki AH, Manno B, Horowitz LN, Iskandrian AS. Poor R wave progression in the precordial leads: clinical implications for the diagnosis of MI. J Am Coll Cardiol. 1983;2:1073–1079
  4. Surawicz B, Van Harne RG, Urbach JR, Bellet S. QS- and QR-pattern in leads V3 and V4 in absence of myocardial infarction: electrocardiographic and vectorcardiographic study. Circulation. 1955;12:391–405
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  7. ACC/AHA 2007 guidelines for the management of patients with unstable angina/non–ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 2002 guidelines for the management of Patients with unstable angina/non–ST-elevation myocardial infarction) developed in collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine. J Am Coll Cardiol. 2007;14:e1–e157
  8. Zema MJ, Kligfield P. Electrocardiographic poor R wave progression II: correlation with angiography. J Electrocardiol. 1979;12:11–15
  9. Marzullo P, Parodi O, Marcassa C, Neglia D, L'Abbate A. When the electrocardiogram fails to define site and extent of myocardial ischemia. Can J Cardiol. 1986;85A–90AJul
  10. Wienbergen H, Gitt AK, Schiele R, Juenger C, Heer T, Vogel C, et al. Different treatments and outcomes of consecutive patients with non–ST-elevation myocardial infarction depending on initial electrocardiographic changes. Am J Cardiol. 2004;93:1543–1546

 Preliminary findings have been presented at the 2008 Canadian Cardiovascular Congress, Toronto, Ontario, Canada.

PII: S0002-9149(09)00725-5

doi: 10.1016/j.amjcard.2009.03.021

American Journal of Cardiology
Volume 104, Issue 2 , Pages 190-193 , 15 July 2009

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