Twenty years of ECG grading of the severity of ischemia

摘要: Shortly following an occlusion of epicardial coronary artery, changes in the surface electrocardiogram (ECG) can be detected. Initially, T waves leads with their positive poles facing ischemic zone become positive, tall and symmetrical. Later, ST segment elevation (STE) becomes apparent. If ischemia continues, terminal portion QRS may also The are believed to caused by prolongation electrical conduction reflect severe due lack protection preconditioning or collateral circulation. Several groups have shown that patients grade 3 higher mortality, incidence reinfarction heart failure than presenting only 2 ischemia, despite equal success recanalizing artery either thrombolytic therapy primary percutaneous intervention. Grade is associated more rapid progression necrosis larger final infarct size. Further studies needed better understand underlying mechanisms determine severity how we should use this method based on standard 12 lead ECG implement clinical therapeutic decisions.