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The Dynamic Nature of ST-Segment and T-Wave Changes During Acute MI

  • Richard A. Harvey (a1) and Frederick P. Fuller (a2)
Abstract

Obtaining aprehospital 12-lead electrocardiogram (ECG) diagnostic of acute myocardial injury has been demonstrated to hasten the administration of thrombolytic agents in the emergency department. This case demonstrates that aprehospital electrocardiogram diagnostic of acute anterior wall infarction can become non-diagnostic following routine administration of oxygen, nitroglycerin, and morphine by paramedics. Although this phenomenon has been observed in the in-hospital setting, it has not been reported in patients with a prehospital ECG.

Copyright
COPYRIGHT: © World Association for Disaster and Emergency Medicine 1997
Corresponding author
Emergency Department, St. Joseph Medical Center, 1718 South I Street, Tacoma, Washington 98405 USA
References
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1. Aufterheide, TP, Hendley, GE, Thakur, RK et al. : The diagnostic impact of prehospital 12-lead electrocardiography. Ann Emerg Med 1990;19:1280–1287.
2. Aufterheide, TP, Hendley, GE, Woo, J et al. : A prospective evaluation of prehospital 12-lead ECG application in chest pain patients. J Electrocardiol (suppl)1992;24:8–13.
3. Kereaikes, DJ, Gibler, WB, Martin, LH et al. : Relative importance of specialized emergency medical system transport and the prehospital electrocardiogram on reducing hospital time delay to therapy for acute myocardial infarction: A preliminary report from the Cincinnati Heart Project. Am Heart J 1992;123:835–840.
4. Karagounis, L, Ipsen, SK, Jessop, MR et al. : Impact of field-transmitted electrocardiography on time to in-hospital thrombolytic therapy in acute myocardial infarction. Am J Cardiol 1990;10:786–791.
5. National Heart Attack Alert Program Coordinating Committee Access to Care Subcommittee: Staffing and equipping emergency medical services systems: Rapid identification and treatment of acute myocardial infarction. Am J Emer Med 1995;13:58–66.
6. Hackett, D, Davies, G, Chierchia, S et al. : Intermittent coronary occlusion in acute myocardial infarction. N Engl J Med 1987;317:1055–1059.
7. Krucoff, M, Wagner, N, Pope, J et al. : The portable programmable microprocessor-driven real time 12-lead electrocardiographic monitor: A preliminary report of a new device for the noninvasive detection of a successful reperfusion of silent coronary reoccclusion. Am J Cardiol 1990;65:143–148.
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Prehospital and Disaster Medicine
  • ISSN: 1049-023X
  • EISSN: 1945-1938
  • URL: /core/journals/prehospital-and-disaster-medicine
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