PMID- 2975319
OWN - NLM
STAT- MEDLINE
DCOM- 19890309
LR  - 20190903
IS  - 0022-0736 (Print)
IS  - 0022-0736 (Linking)
VI  - 21 Suppl
DP  - 1988
TI  - False-positive posterior myocardial infarct criteria during left anterior 
      descending coronary angioplasty.
PG  - S105-11
AB  - In reviewing ECG change during acute anterior myocardial infarction (AMI) and 
      during transluminal coronary angioplasty of the left anterior descending (LAD) 
      coronary artery, QRS changes mimicking posterior myocardial infarct (PMI) and 
      false-positive points for PMI using the QRS infarct size scoring system were 
      observed in about 20% of patients. Nineteen patients in whom a three-lead 
      electrocardiogram (ECG) was continuously recorded during transluminal coronary 
      angioplasty of a proximal left anterior descending (LAD) coronary artery were 
      reviewed. All but two had significant ST-segment shifts in V2 within a few 
      seconds of balloon occlusion of a proximal LAD. In many such patients the R wave 
      amplitude in V2 measured from the PR segment baseline remained relatively stable 
      and the S amplitude tracked with the J. point. However, of the 19 patients 
      studied, 11 had transient QRS changes greater than could be accounted for by 
      baseline shift alone and 4 had transient false-positive PMI points by QRS MI size 
      score. Transient QRS changes were observed as follows: (1) significant increase 
      in R waves and/or decrease in S waves in V2 due to right septal block (or 
      conduction delay) occurred in 3 of 11 patients and was the cause of the 
      false-positive criteria for PMI; (2) 5 of 11 patients had a major decrease in R 
      waves in V2 due to left septal block; (3) 2 of 11 patients had both (1) and (2); 
      and (4) 1 of 11 had transient frontal plane axis shifts with the QRS 
      configuration of anterosuperior fascicular block plus right and left septal 
      block.(ABSTRACT TRUNCATED AT 250 WORDS)
FAU - Selvester, R H
AU  - Selvester RH
AD  - Department of Medicine, University of Southern California/Rancho Los Amigos 
      Medical Center, Downey 90242.
FAU - Wagner, N B
AU  - Wagner NB
FAU - Wagner, G S
AU  - Wagner GS
LA  - eng
GR  - HL-17670/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - J Electrocardiol
JT  - Journal of electrocardiology
JID - 0153605
SB  - IM
MH  - *Angioplasty, Balloon
MH  - Coronary Disease/therapy
MH  - Coronary Vessels
MH  - *Electrocardiography
MH  - False Positive Reactions
MH  - Heart Conduction System/*physiopathology
MH  - Humans
MH  - Intraoperative Care
MH  - *Monitoring, Physiologic
MH  - Myocardial Infarction/*diagnosis
EDAT- 1988/01/01 00:00
MHDA- 1988/01/01 00:01
CRDT- 1988/01/01 00:00
PHST- 1988/01/01 00:00 [pubmed]
PHST- 1988/01/01 00:01 [medline]
PHST- 1988/01/01 00:00 [entrez]
AID - 10.1016/0022-0736(88)90069-6 [doi]
PST - ppublish
SO  - J Electrocardiol. 1988;21 Suppl:S105-11. doi: 10.1016/0022-0736(88)90069-6.