Assessment of ECG Criteria for the Diagnosis of Right Ventricular Involvement.

Q2 Medicine

Oman Medical Journal Pub Date : 2024-07-31 eCollection Date: 2024-07-01 DOI:10.5001/omj.2024.85

Suhaib Al-Mashari, Reem Al-Habsi, Amal Al-Habsi, Yasir Al-Malki, Mashaal Al-Saadi, Adil Al-Riyami, Sunil K Nadar

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Abstract

Objectives: This study was performed to assess the accuracy of standard electrocardiographic criteria in diagnosing of right ventricular (RV) involvement in patients with inferior myocardial infarction (IMI).

Methods: This was a retrospective analysis of patients admitted with an IMI. Proximal occlusion of the right coronary artery before the origin of the RV branch on angiography was considered diagnostic of RV involvement.

Results: The subjects were 129 patients (mean age = 55.8±13.1 years; 81.4% male) with inferior ST-elevation myocardial infarction. The most sensitive indicators of RV involvement were an ST elevation in V4R (72.9%) and a higher ST elevation in lead III than in lead II (80.4%). The most specific indicators were ST elevation in V1 (88.7%) and ST elevation in V1 with ST depression in V2 (97.1%). Combining all the criteria improved sensitivity to 85.7% but reduced specificity to 21.2%.

Conclusions: No single electrocardiogram criterion was able to identify all cases of RV involvement in patients with IMI. Combining the different criteria helped pick up more cases at the cost of increasing false positives.

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右室受累心电图诊断标准的评价。

研究目的本研究旨在评估标准心电图标准在诊断下壁心肌梗死（IMI）患者右心室受累方面的准确性：这是对因心肌梗死入院的患者进行的回顾性分析。在血管造影中，右冠状动脉在 RV 支起源之前的近端闭塞被认为是 RV 受累的诊断依据：研究对象为129名ST段抬高型心肌梗死患者（平均年龄为55.8±13.1岁，81.4%为男性）。RV受累的最敏感指标是V4R的ST段抬高（72.9%）和III导联的ST段抬高高于II导联（80.4%）。最特异的指标是 V1 的 ST 基底抬高（88.7%）和 V1 的 ST 基底抬高伴 V2 的 ST 基底压低（97.1%）。综合所有标准后，灵敏度提高到 85.7%，但特异性降低到 21.2%：结论：没有一种单一的心电图标准能够识别所有IMI患者的RV受累病例。结合不同的标准有助于发现更多病例，但代价是增加了假阳性率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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