Increased QT Interval Dispersion in Diagnosis of Acute Coronary Syndrome with Atypical Symptoms and EKG
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| Format: | Artículo científico |
| Langue: | en |
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Medical Education Cooperation with Cuba
2014
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| _version_ | 1876486382249050112 |
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| author | Fernando Rodríguez |
| author_facet | Fernando Rodríguez |
| contents | Increased QT Interval Dispersion in Diagnosis of Acute Coronary Syndrome with Atypical Symptoms and EKG Fernando Rodríguez Elibet Chávez Wilfredo J. Machín Alain Alonso Vielka González Medicina Cuba prognosis Risk factors myocardial ischemia electrocardiography INTRODUCTION EKG remains a highly valuable tool for heart disease management. Corrected QT interval dispersion is a useful EKG parameter to assess prognosis in ischemic heart disease and specifically acute coronary syndrome. Understanding QT interval physiopathology helps assess importance of QT measurement in this context. Although increased QT dispersion is an ominous prognostic marker, its utility has not been evaluated for all types of acute coronary syndrome, even though in many circumstances it is the only tool available for diagnosing patients with equivocal EKG signs and/or atypical symptoms. OBJECTIVE Describe corrected QT interval dispersion in acute coronary syndrome in three groups of patients—with ST elevation, without ST elevation, and without ST elevation with equivocal EKG signs— admitted to the intensive care unit of Celestino Hernández Robau University Hospital in Santa Clara, Cuba, from January 2010 through June 2011. METHODS A descriptive retrospective study was conducted in 194 patients admitted with diagnosis of acute coronary syndrome. QT interval was measured and its dispersion calculated for the first EKG after symptom onset. Patterns were assessed for typical and atypical clinical presentations, and unequivocal and equivocal EKG signs. RESULTS Nonclassifiable acute coronary syndrome was found in 6.7% of patients (13/194), the majority of whom had increased QT dispersion (76.9%, 10/13). There were significant differences in QT dispersion patterns between patients with typical and atypical presentations and between patients with equivocal and unequivocal EKG findings. In non-ST elevation acute coronary syndrome and nonclassifiable acute coronary syndrome with increased dispersion, atypical presentation was the most common (65.5%, 19/29; and 90%, 9/10, respectively). CONCLUSIONS Corrected QT interval dispersion is a useful diagnostic tool for acute coronary syndrome, especially when patients present with atypical symptoms and equivocal EKG findings. Thus, it is a low-cost alternative in management of acute coronary syndrome in resource-poor settings. 2014 artículo científico 1555-7960 https://www.redalyc.org/articulo.oa?id=437542098009 en http://www.redalyc.org/revista.oa?id=4375 MEDICC Review application/pdf Medical Education Cooperation with Cuba MEDICC Review (Estados Unidos de América) Num.3-4 Vol.16 |
| format | Artículo científico |
| id | redalyc_437542098009 |
| institution | Redalyc |
| language | en |
| publishDate | 2014 |
| publisher | Medical Education Cooperation with Cuba |
| spellingShingle | Increased QT Interval Dispersion in Diagnosis of Acute Coronary Syndrome with Atypical Symptoms and EKG Fernando Rodríguez Medicina Cuba prognosis Risk factors myocardial ischemia electrocardiography Increased QT Interval Dispersion in Diagnosis of Acute Coronary Syndrome with Atypical Symptoms and EKG Fernando Rodríguez Elibet Chávez Wilfredo J. Machín Alain Alonso Vielka González Medicina Cuba prognosis Risk factors myocardial ischemia electrocardiography INTRODUCTION EKG remains a highly valuable tool for heart disease management. Corrected QT interval dispersion is a useful EKG parameter to assess prognosis in ischemic heart disease and specifically acute coronary syndrome. Understanding QT interval physiopathology helps assess importance of QT measurement in this context. Although increased QT dispersion is an ominous prognostic marker, its utility has not been evaluated for all types of acute coronary syndrome, even though in many circumstances it is the only tool available for diagnosing patients with equivocal EKG signs and/or atypical symptoms. OBJECTIVE Describe corrected QT interval dispersion in acute coronary syndrome in three groups of patients—with ST elevation, without ST elevation, and without ST elevation with equivocal EKG signs— admitted to the intensive care unit of Celestino Hernández Robau University Hospital in Santa Clara, Cuba, from January 2010 through June 2011. METHODS A descriptive retrospective study was conducted in 194 patients admitted with diagnosis of acute coronary syndrome. QT interval was measured and its dispersion calculated for the first EKG after symptom onset. Patterns were assessed for typical and atypical clinical presentations, and unequivocal and equivocal EKG signs. RESULTS Nonclassifiable acute coronary syndrome was found in 6.7% of patients (13/194), the majority of whom had increased QT dispersion (76.9%, 10/13). There were significant differences in QT dispersion patterns between patients with typical and atypical presentations and between patients with equivocal and unequivocal EKG findings. In non-ST elevation acute coronary syndrome and nonclassifiable acute coronary syndrome with increased dispersion, atypical presentation was the most common (65.5%, 19/29; and 90%, 9/10, respectively). CONCLUSIONS Corrected QT interval dispersion is a useful diagnostic tool for acute coronary syndrome, especially when patients present with atypical symptoms and equivocal EKG findings. Thus, it is a low-cost alternative in management of acute coronary syndrome in resource-poor settings. 2014 artículo científico 1555-7960 https://www.redalyc.org/articulo.oa?id=437542098009 en http://www.redalyc.org/revista.oa?id=4375 MEDICC Review application/pdf Medical Education Cooperation with Cuba MEDICC Review (Estados Unidos de América) Num.3-4 Vol.16 |
| title | Increased QT Interval Dispersion in Diagnosis of Acute Coronary Syndrome with Atypical Symptoms and EKG |
| topic | Medicina Cuba prognosis Risk factors myocardial ischemia electrocardiography |
| url | https://www.redalyc.org/articulo.oa?id=437542098009 |