tag:blogger.com,1999:blog-549949223388475481.post2275139350437405220..comments2024-03-26T22:42:04.176-05:00Comments on Dr. Smith's ECG Blog: Intermittent third degree heart block due to stuttering inferior STEMIUnknownnoreply@blogger.comBlogger3125tag:blogger.com,1999:blog-549949223388475481.post-19426682161810165742018-03-26T09:22:54.903-05:002018-03-26T09:22:54.903-05:00Thank you sirThank you sirGreenhttps://www.blogger.com/profile/07612896010522381195noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-58479899008158767322018-03-25T15:34:54.584-05:002018-03-25T15:34:54.584-05:00Here is the abstract of a paper we have submitted:...Here is the abstract of a paper we have submitted:<br /><br />ABSTRACT<br />Introduction<br />Right ventricular myocardial infarction (RVMI) comprises 20-30% of inferior ST elevation MI (STEMI). It is an important entity to recognize as RVMI is associated with significant short term morbidity and mortality. RVMI diagnosis has conventionally required obtaining a right sided ECG. Our objective is to evaluate, in the presence of inferior myocardial infarction (MI), the sensitivity and specificity the standard 12-lead electrocardiogram (ECG) for right ventricular MI (RVMI).<br />Methods<br /> We retrospectively studied a cohort of consecutive inferior STEMI, comparing the ECGs of patients with, to those without, RVMI, as determined by angiographic coronary occlusion proximal to the RV marginal branch. ST segments were measured in leads I, II, III, aVF, V1, and V2. The primary outcome was sensitivity and specificity of 1) ST depression (STD) in lead I and 2) ST Elevation (STE) in lead V1, stratified by presence or absence of posterior MI, as determined by STD in lead V2, for differentiating RVMI from non-RVMI. <br />Results<br /> Of 149 patients with inferior STEMI, 43 (29%) had RVMI and 106 (71%) did not. There was no difference in STD in Lead I between patients with (37/43, 86%) and without RVMI (85/106, 80%, p=0.56). Of patients with RVMI, (15/43, 35%) had STE in V1, versus (17/106, 16%) without RVMI (p = 0.015). Specificity of STE in lead V1 for RVMI was 84% and sensitivity was 35%. Sensitivity of STE in V1 was higher with STD in V2 (69%) than without (15%) (p < 0.001).<br />Conclusion<br /> Among inferior STEMI, the presence of ST depression in lead I is not specific for differentiating RVMI from non-RVMI. ST elevation in lead V1 is specific, and when there is no concomitant STD in V2, it is moderately sensitive for RVMI. Diagnostic characteristics of the standard 12-lead ECG are inadequate to reliably diagnose RVMI.<br />Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-26247865648867886602018-03-25T11:30:04.246-05:002018-03-25T11:30:04.246-05:00Dr Smith, in the context of inferior STEMI, I thin...Dr Smith, in the context of inferior STEMI, I think STE in V1 may be relating to RVMI. What your opinion about this?Greenhttps://www.blogger.com/profile/07612896010522381195noreply@blogger.com