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Subendocardial injury pattern

Figure 3.9 In case that in basal state a certain degree of ischaemia with subendocardial predominance exists too mild to produce clear ECG changes, an increase of active ischaemia still with subendocardial predominance will produce an ST-segment depression (subendocardial injury pattern) (A). If as a consequence of ischaemia there is a delay in repolarisation predominating in subepicardium or being transmural, a flattened or negative T wave appears in leads with, but also without, predominant R wave (B-1) (subepicardial ischaemia pattern). The latter pattern is... Figure 3.9 In case that in basal state a certain degree of ischaemia with subendocardial predominance exists too mild to produce clear ECG changes, an increase of active ischaemia still with subendocardial predominance will produce an ST-segment depression (subendocardial injury pattern) (A). If as a consequence of ischaemia there is a delay in repolarisation predominating in subepicardium or being transmural, a flattened or negative T wave appears in leads with, but also without, predominant R wave (B-1) (subepicardial ischaemia pattern). The latter pattern is...
Both the clinical ST-segment depression pattern and the experimental subendocardial injury pattern have a common explanation the sum of subendocardium TAP, which is of worse quality than in the subepicardium (Figure 4.5), or the generation of an injury vector (Figure 4.8). In NSTE-ACS the presence of new ST-segment depression is related with the presence of evident active ischaemia predominantly in the subendocardium. On the other hand, the presence of flat or negative T wave is related with previous ischaemia (often is a reperfusion pattern) without subendocardial predominance (Table 2.1 and Figure 3.9). [Pg.60]

In case of ACS with ST-segment elevation (STE-ACS), the ECG patterns of ischaemia (subendocardial), injury (transmural) and usually necrosis appear in a sequential way (see Figures 3.7 and 8.5). In the case of exercise angina, the ECG pattern of subendocardial injury is the most frequently found (see Figures 3.9A and 4.57). [Pg.19]

When acute coronary occlusion is carried out in experimental animals with closed thorax, it gives rise, during the initial phase of ischaemia, to a delay in repolarisation (TAP) in the subendocardium, which is the area that first suffers ischaemia (Lengyel et al, 1957). This subendocardial ischaemia is evidenced by a tall and peaked T wave immediately followed by ST-segment elevation (injury pattern) if the occlusion persists and the ischaemia becomes severe and transmural (see ECG pattern of injury p. 55). This pattern maybe self-limited if the occlusion is temporary, as in coronary spasm (Prinzmetal... [Pg.33]

Figure 3.4 Electrocardiographic - pathological correlations after the occlusion of a coronary artery in an experimental animal with its thorax closed. It changes from a subendocardial ischemia pattern (tall and peaked T wave) to a pattern of a subepicardial injury, transmural in clinical practice, (ST segment elevation) when the acute clinical ischemia is more severe. Finally, the "q wave of... Figure 3.4 Electrocardiographic - pathological correlations after the occlusion of a coronary artery in an experimental animal with its thorax closed. It changes from a subendocardial ischemia pattern (tall and peaked T wave) to a pattern of a subepicardial injury, transmural in clinical practice, (ST segment elevation) when the acute clinical ischemia is more severe. Finally, the "q wave of...
Electrocardiographic pattern of subendocardial injury in patients with narrow QRS diagnosis and differential diagnosis... [Pg.110]

The ECG pattern of subendocardial injury (ST-segment depression) is found in different clinical settings of IHD (Figures 4.57-4.64), but may also be observed in other situations (Figure 4.65). We will now discuss the diagnostic... [Pg.110]

The electrocardiographic pattern of subendocardial injury in patients with ACSs is recorded in different leads, depending on the coronary artery involved and the location of the injured area. When the ischaemia is due to left main trunk (LMT) subocclusion or equivalent, or 3 proximal vessel diseases, the involvement of the left ventricle is circumferential. In case of single vessel disease or when in presence of multivessel disease, the active ischaemia is due to a culprit artery or two distal occlusions the involvement is considered regional (Sclarovsky 1989). The correlation between these... [Pg.113]

In first part we have discussed the criteria for diagnosis and location of ST-segment elevation (pattern of subepicardium injury) and ST-segment depression or negative T wave (pattern of subendocardial injury and subepicardial ischaemia). Now we will discuss the clinical evolution, prognostic implications and risk stratification of these patterns. [Pg.210]

Figure 4.5 How the respective patterns of subendocardial (B) and subepicardial (C) injuries are generated according to the theory that the normal ECG pattern (A) is the result of the sum of subendocardial and subepicardial PATs. Figure 4.5 How the respective patterns of subendocardial (B) and subepicardial (C) injuries are generated according to the theory that the normal ECG pattern (A) is the result of the sum of subendocardial and subepicardial PATs.
In theory the presence of subendocardial or transmural injury in completely opposite areas of the heart may decrease or even conceal the two injury vectors (Madias, 2006). However, in practice, this does not occur usually, because the ischaemia is usually due to occlusion of only one vessel and this does not generate equal and opposed injured areas (Rautaharju, 2006). Furthermore, with the same amount of injury in two opposite areas, it is more visible in the surface ECG of the injury area that is more close to subepicardium. In the chronic phase it is more often seen that a new vector of infarction in opposed area may cancel the Q-wave pattern of a previous infarction (see Figure 5.38). [Pg.62]

Type and location of the ischemia due to ACS - Usually transmural and homogeneous - Located in anteroseptal (f ST Vi 2 a V3) I or VL) or inferolateral zone (t ST II, III, and sometimes I, VL, Vs and/or [ ST V,-V3. - See atypical patterns (fig 8.3) - Often not easy to locate - When ST depression is in >7 leads with elevation in VR, the injury is very extensive (circumferential) and predominantly subendocardial - non-complete occlusion of the main trunk (LMT) or proximal occlusion of LAD + LCX (equivalent) - The ischemia is regional when the ST depression is only present in a few leads (<6) - Flat or negative T wave is due to delay of repolarization that has no subendocardial predominance. [Pg.215]

ECG pattern of subendocardial ischaemia and the pattern of subepicardial ischaemia. Slight ST-segment elevation may be noted in V1 lead. (B) Few hours later appeared typical pattern of subepicardial injury (ST-segment elevation) with QS of necrosis in V2-V4. [Pg.218]


See other pages where Subendocardial injury pattern is mentioned: [Pg.20]    [Pg.60]    [Pg.60]    [Pg.125]    [Pg.289]    [Pg.297]    [Pg.20]    [Pg.60]    [Pg.60]    [Pg.125]    [Pg.289]    [Pg.297]    [Pg.57]    [Pg.239]    [Pg.297]    [Pg.1626]    [Pg.156]   
See also in sourсe #XX -- [ Pg.20 , Pg.32 , Pg.35 , Pg.58 , Pg.237 , Pg.275 ]




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Injury patterns

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