TY - JOUR
T1 - Ischemic blocks during early phase of anterior myocardial infarction
T2 - Correlation with st‐segment shift
AU - Sclarovsky, S.
AU - Sagie, A.
AU - Strasbero, B.
AU - Shnapick, Y.
AU - Rechavia, E.
AU - Kusniec, J.
AU - Agmon, J.
PY - 1988/11
Y1 - 1988/11
N2 - Of 760 consecutive cases with anterior acute myocardial infarction (AMI), 55 developed acute bundle‐branch block (BBB), fascicular block, or high‐degree atrioventricular block during the hyperacute ECG stage of AMI. According to the direction of the ST segment during the acute ischemic episode, patients were divided into two groups. Group A consisted of 32 patients who developed BBB during ST‐segment elevation, positive T wave, and absent or minimal Q wave. Group B consisted of 23 patients who developed BBB during ST‐segment depression and evolved into anterior AMI. Group A was characterized by a higher incidence of right BBB and left anterior hemiblock [91% vs. 26% and 56% vs. 13%, respectively (p<0.005)]. Group B was characterized by a higher incidence of left BBB and left posterior hemiblock [57% vs. 9% and 26% vs. 12%, respectively (p<0.001)]. The BBB was transient (disappearing within hours to one day) in 14 patients in Group A and in 5 patients in Group B. The incidence of progression to high‐degree atrioventricular block was almost equal in the two groups (25% and 26%). The mortality rate was very high in both groups, but higher in Group B [74% vs. 59% (p=NS)] especially in those with LBBB (85%). Most patients died on the day of occurrence of BBB [Group A, 50% vs. Group B, 70% (p=NS)]. The causes of death in both groups were cardiogenic shock and/or electromechanical dissociation. It is concluded that there is a correlation between the ECG pattern of ST‐segment shift and the type of BBB, and that cardiac mortality is very high in this group of patients, especially in those with ST‐segment depression and left BBB.
AB - Of 760 consecutive cases with anterior acute myocardial infarction (AMI), 55 developed acute bundle‐branch block (BBB), fascicular block, or high‐degree atrioventricular block during the hyperacute ECG stage of AMI. According to the direction of the ST segment during the acute ischemic episode, patients were divided into two groups. Group A consisted of 32 patients who developed BBB during ST‐segment elevation, positive T wave, and absent or minimal Q wave. Group B consisted of 23 patients who developed BBB during ST‐segment depression and evolved into anterior AMI. Group A was characterized by a higher incidence of right BBB and left anterior hemiblock [91% vs. 26% and 56% vs. 13%, respectively (p<0.005)]. Group B was characterized by a higher incidence of left BBB and left posterior hemiblock [57% vs. 9% and 26% vs. 12%, respectively (p<0.001)]. The BBB was transient (disappearing within hours to one day) in 14 patients in Group A and in 5 patients in Group B. The incidence of progression to high‐degree atrioventricular block was almost equal in the two groups (25% and 26%). The mortality rate was very high in both groups, but higher in Group B [74% vs. 59% (p=NS)] especially in those with LBBB (85%). Most patients died on the day of occurrence of BBB [Group A, 50% vs. Group B, 70% (p=NS)]. The causes of death in both groups were cardiogenic shock and/or electromechanical dissociation. It is concluded that there is a correlation between the ECG pattern of ST‐segment shift and the type of BBB, and that cardiac mortality is very high in this group of patients, especially in those with ST‐segment depression and left BBB.
KW - ST‐segment shift
KW - acute myocardial infarction
KW - bundle‐branch block
UR - http://www.scopus.com/inward/record.url?scp=0023792323&partnerID=8YFLogxK
U2 - 10.1002/clc.4960111107
DO - 10.1002/clc.4960111107
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C2 - 3233802
AN - SCOPUS:0023792323
SN - 0160-9289
VL - 11
SP - 757
EP - 762
JO - Clinical Cardiology
JF - Clinical Cardiology
IS - 11
ER -