Acute Coronary Syndrome or better known as ACS consist of a spectrum of thrombotic coronary artery disease ranging from unstable angina to both STEMI and nonSTEMI.ECG: T wave tenting or inversion, ST elevation or depression (including Jpoint elevation in multiple leads) and pathologic Q waves.
Troponin I or T is the most sensitive determinant of ACS
Marriott's Criteria
Epicardial injury is diagnosed when Jpoint elevated by 1 mm or more in two or more limb leads or precordial leads v4 to v6 or by 2mm or more in two or more precordial leads v1 to v3. Serial cardiac marker determines confirm myocardial injury or infarction in more than 90% of patient with Jpoint elevation in the limb leads.
Significant Q wave = > 0.04 sec in duration & at least 1/4 of the corresponding R wave height.
Isolated small Q wave II, III and aVF & lead I and aVL frequently normal (these small Q waves are known as septal Q waves because of the origin of the initial vector in ventricular depolarization)
from 1 - 4% patients ultimately proven to have ACS are sent home from ED.
No comments:
Post a Comment