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358 Cardio Diabetes Medicine 2017

ECG Evaluation in Patients with

Acute Coronary Syndrome

Dr. Senthilkumar Nallusamy*

Dr. A. Balaji**

Dr. M. Shyamala Priya***

*Chief Cardiologist, Apollo Hospital, Trichy And Rana Hospital, Trichy
**& ***Resident, Apollo Hospital, Trichy.

Introduction: ECG Criteria for Acute Stemi in The Absence
The goal of the emergency department evaluation is of LBBB:
to determine the cause of the chest discomfort and ACC / AHA / World Heart Federation Committeepro-
promptly initiate appropriate therapy. It is essential posed the below definition of ECG criteria for diag-
that the initial ECG evaluation should be accurate and nosing STEMI:
rapid so that one can plan the treatment strategy ac-
cordingly and evidence based. New ST elevation atthe Jpoint in two contiguous
leads with >0.1 mv (1mm)in anterior leads except V2-
In general, a resting ECG should be obtained in all V3. (See figure-1)
adults with chest pain presenting to the emergency
department.ECG is the mainstay in the initial diagno- In leads V2 – V3, the following points apply:
sis of patients with suspected Acute Coronary Syn- a. >0.2 mv(2mm) in men ≥ 40 years
drome (ACS).
b. >0.25mv(2.5mm) in men ≤ 40 years
Usefulness of ECG: c. >0.15mv (1.5 mm)in women.
1. From the ECG, we can categorise patients with Figure -1
chestpain into one of the below three groups:

2. ST Elevation MI ( STEMI or new onset LBBB)
3. Non- ST Elevation MI (NSTEMI) or Unstable Angina
Undifferentiated chest pain syndrome

I. ECG in Stemi:

ECG in patients with STEMI is useful in the
following ways:-
* In diagnosing
* Localising the MI
SGARBOSSA’S ECG CRITERIA FOR
* Extent of Myocardial injury DIAGNOSING ACUTE STEMI IN THE

* Age of the infarct PRESENCE OF LBBB
* To identify the infarct related artery.
* Presence of conduction defects. Ecg Criteria Points
St Segment Elevation Of > 1Mm 5
And Concordant With The QRS
Complex

GCDC 2017