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ECG signs of acute myocardial ischemiain the prehospital setting of a suspected acute coronary syndrome and its association with outcomes
University of Borås, School of Health Science.
University of Borås, School of Health Science. (Prehospital akutsjukvård)
University of Borås, School of Health Science.
University of Borås, School of Health Science. (Prehospital akutsjukvård)
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2014 (English)In: American Journal of Emergency Medicine, ISSN 0735-6757, E-ISSN 1532-8171, Vol. 32, no 6, 601-605 p.Article in journal (Refereed) Published
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Abstract [en]

AIMS: The aims of this study were (a) to determine the prehospital prevalence of electrocardiographic (ECG) signs of acute myocardial ischemia in patients with suspected acute coronary syndrome and (b) to describe the relationships between the various ECG patterns and the diagnosis of acute myocardial infarction (AMI) and outcomes. METHODS: Prospective cohort study using data from an interventional trial in acute chest pain patients transported by the emergency medical services. These patients were classified into 3 groups: patients with ECG showing signs of acute myocardial ischemia, patients with ECG showing other abnormal changes (bundle-branch block, pacemaker rhythm, Q-wave or T-wave inversion) and patients without significant pathologic findings. All P values are age-adjusted. RESULTS: Among 1546 patients, 312 (20%) had ECG signs of acute myocardial ischemia. Of them, 57% had a final diagnosis of AMI versus 26% of those with other abnormal ECGs and 12% of those with ECG without significant pathologic findings (P<.0001). In all, 53% of all AMI cases involved patients without ECG signs of acute myocardial ischemia. Although ECG signs of acute myocardial ischemia predicted heart failure and ventricular tachyarrhythmias both prior to and after hospital admission, there was no significant difference in 30-day mortality between the 3 patient groups (4.3%, 3.7%, and 1.2%, respectively, P=.11). CONCLUSION: Among patients with a clinical suspicion of AMI in the prehospital setting, the prevalence of ECG signs suggesting AMI was low, as was the ability to identify AMI patients using ECG findings only. We therefore need better instruments in the prehospital triage of patients with acute chest pain.

Place, publisher, year, edition, pages
W.B. Saunders Co. , 2014. Vol. 32, no 6, 601-605 p.
Keyword [sv]
Prehospital Akutsjukvård
National Category
Cardiac and Cardiovascular Systems
Research subject
Integrated Caring Science
Identifiers
URN: urn:nbn:se:hb:diva-1993DOI: 10.1016/j.ajem.2014.03.006PubMedID: 24731933Local ID: 2320/14541OAI: oai:DiVA.org:hb-1993DiVA: diva2:870074
Available from: 2015-11-13 Created: 2015-11-13 Last updated: 2017-05-04

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