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

Published online by Cambridge University Press:  28 June 2012

Richard A. Harvey  and
Frederick P. Fuller
Richard A. Harvey*
Affiliation:
Department of Emergency Medicine, St. Joseph Medical Center, Tacoma, Washington, USA
Frederick P. Fuller
Affiliation:
Quality Improvement Manager, American Medical Response, Tacoma, Washington, USA
*
Emergency Department, St. Joseph Medical Center, 1718 South I Street, Tacoma, Washington 98405 USA
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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.

Keywords

ACLS protocolcoronary ischemiacoronary reocclusionemergency medical servicesmyocardial infarctmyocardial ischemiaparamedicST segment elevation
Type
Case Report
Information
Prehospital and Disaster Medicine , Volume 12 , Issue 4 , December 1997 , pp. 80 - 84
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1997

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References

1. Aufterheide, TP, Hendley, GE, Thakur, RK et al. : The diagnostic impact of prehospital 12-lead electrocardiography. Ann Emerg Med 1990;19:1280–1287.CrossRefGoogle Scholar
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.CrossRefGoogle Scholar
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.CrossRefGoogle Scholar
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.CrossRefGoogle Scholar
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.Google Scholar
6. Hackett, D, Davies, G, Chierchia, S et al. : Intermittent coronary occlusion in acute myocardial infarction. N Engl J Med 1987;317:1055–1059.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle Scholar