Myocardial Infarction: Difference between revisions

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== Electrocardiogram (ECG) ==
== Electrocardiogram (ECG) ==
An electrocardiogram (ECG) should be made within 10 minutes of arrival in every patient with suspected ACS. <Cite>REFNAME10</Cite>
An electrocardiogram (ECG) should be made within 10 minutes of arrival in every patient with suspected ACS. <Cite>REFNAME10</Cite>


The ECG is an important and easy modality which can assist in the diagnosis and prognostication of ACS.
The ECG is an important and easy modality which can assist in the diagnosis and prognostication of ACS.


It can however take 90 minutes after the onset of the symptoms to see abnormalities on the ECG. Furthermore, the ECG does not reflect the dynamic pathophysiology of the ACS. Therefore it is important to make serial ECGs, certainly if a patient has ongoing symptoms. <Cite>REFNAME11</Cite>
It can however take 90 minutes after the onset of the symptoms to see abnormalities on the ECG. Furthermore, the ECG does not reflect the dynamic pathophysiology of the ACS. Therefore it is important to make serial ECGs, certainly if a patient has ongoing symptoms. <Cite>REFNAME11</Cite>


Furthermore, the ECG is also helpful in localising the ischemia:  
Furthermore, the ECG is also helpful in localising the ischemia:  
:Anterior wall ischemia - One or more of leads V1-V6  
*Anterior wall ischemia - One or more of leads V1-V6  
:Anteroseptal ischemia - Leads V1 to V3
*Anteroseptal ischemia - Leads V1 to V3
:Apical or lateral ischemia - Leads aVL and I, and leads V4 to V6
*Apical or lateral ischemia - Leads aVL and I, and leads V4 to V6
:Inferior wall ischemia - Leads II, III, and aVF
*Inferior wall ischemia - Leads II, III, and aVF
:Posterior wall – Leads V7-V9  
*Posterior wall – Leads V7-V9  
:Right ventricle – Leads V3R, V4R  
*Right ventricle – Leads V3R, V4R  
:Left main coronary artery ischemia – Lead aVR
*Left main coronary artery ischemia – Lead aVR


== Cardiac Markers ==
== Cardiac Markers ==