Typical chest pain and precordial leads ST-elevation in patients with pacemakers - are we always looking at an acute myocardial infarction?
Introduction. Electrocardiographic (ECG) diagnosis of acute myocardial infarction (AMI) in patients with paced rhythm is difficult. Sgarbossa’s criteria represent helpful diagnostic ECG tool. Case report. A 57-year-old female patient with paroxysmal atrial fibrillation and a permanent pacem...
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| Format: | Article |
| Language: | English |
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Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade
2015-01-01
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| Series: | Vojnosanitetski Pregled |
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| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2015/0042-84501500061O.pdf |
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| author | Ostojić Marina M. Potpara Tatjana S. Polovina Marija M. Ostojić Mladen M. Ostojić Miodrag C. |
| author_facet | Ostojić Marina M. Potpara Tatjana S. Polovina Marija M. Ostojić Mladen M. Ostojić Miodrag C. |
| author_sort | Ostojić Marina M. |
| collection | DOAJ |
| description | Introduction. Electrocardiographic (ECG) diagnosis of acute myocardial
infarction (AMI) in patients with paced rhythm is difficult. Sgarbossa’s
criteria represent helpful diagnostic ECG tool. Case report. A 57-year-old
female patient with paroxysmal atrial fibrillation and a permanent pacemaker
presented in the Emergency Department with prolonged typical chest pain and
ECG recording suggestive for AMI. Documented ECG changes correspond to the
first Sgarbossa’s criterion for AMI in patients with dual pacemakers
(ST-segment elevation of ≥ 5 mm in the presence of the negative QRS complex).
The patient was sent to catheterization lab where coronary angiogram reveled
normal findings. ECG changes occurred due to pericardial reaction following
two interventions: pacemaker implantation a month before and radiofrequency
catheter ablation of AV junction two weeks before presentation in Emergency
Department. Conclusion. This case report points out to the limitations of
proposed criteria that aid in the recognition of AMI in patients with
underlying paced rhythm and possible cause(s) of transient
electrocardiographic abnormalities. |
| format | Article |
| id | doaj-art-b5f33cc512844bb5b6c03803b127cbdb |
| institution | DOAJ |
| issn | 0042-8450 2406-0720 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade |
| record_format | Article |
| series | Vojnosanitetski Pregled |
| spelling | doaj-art-b5f33cc512844bb5b6c03803b127cbdb2025-08-20T03:05:10ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202015-01-0172983784010.2298/VSP130916061O0042-84501500061OTypical chest pain and precordial leads ST-elevation in patients with pacemakers - are we always looking at an acute myocardial infarction?Ostojić Marina M.0Potpara Tatjana S.1Polovina Marija M.2Ostojić Mladen M.3Ostojić Miodrag C.4Clinical Center of Serbia, Clinic of Cardiology, BelgradeClinical Center of Serbia, Clinic of Cardiology, Belgrade + Faculty of Medicine, BelgradeClinical Center of Serbia, Clinic of Cardiology, BelgradeClinical Center of Serbia, Clinic of Cardiology, BelgradeFaculty of Medicine, BelgradeIntroduction. Electrocardiographic (ECG) diagnosis of acute myocardial infarction (AMI) in patients with paced rhythm is difficult. Sgarbossa’s criteria represent helpful diagnostic ECG tool. Case report. A 57-year-old female patient with paroxysmal atrial fibrillation and a permanent pacemaker presented in the Emergency Department with prolonged typical chest pain and ECG recording suggestive for AMI. Documented ECG changes correspond to the first Sgarbossa’s criterion for AMI in patients with dual pacemakers (ST-segment elevation of ≥ 5 mm in the presence of the negative QRS complex). The patient was sent to catheterization lab where coronary angiogram reveled normal findings. ECG changes occurred due to pericardial reaction following two interventions: pacemaker implantation a month before and radiofrequency catheter ablation of AV junction two weeks before presentation in Emergency Department. Conclusion. This case report points out to the limitations of proposed criteria that aid in the recognition of AMI in patients with underlying paced rhythm and possible cause(s) of transient electrocardiographic abnormalities.http://www.doiserbia.nb.rs/img/doi/0042-8450/2015/0042-84501500061O.pdfpacemaker, artificialmyocardial infarctionpericarditisheart conduction systemcatheterablationdiagnosis, differential |
| spellingShingle | Ostojić Marina M. Potpara Tatjana S. Polovina Marija M. Ostojić Mladen M. Ostojić Miodrag C. Typical chest pain and precordial leads ST-elevation in patients with pacemakers - are we always looking at an acute myocardial infarction? Vojnosanitetski Pregled pacemaker, artificial myocardial infarction pericarditis heart conduction system catheterablation diagnosis, differential |
| title | Typical chest pain and precordial leads ST-elevation in patients with pacemakers - are we always looking at an acute myocardial infarction? |
| title_full | Typical chest pain and precordial leads ST-elevation in patients with pacemakers - are we always looking at an acute myocardial infarction? |
| title_fullStr | Typical chest pain and precordial leads ST-elevation in patients with pacemakers - are we always looking at an acute myocardial infarction? |
| title_full_unstemmed | Typical chest pain and precordial leads ST-elevation in patients with pacemakers - are we always looking at an acute myocardial infarction? |
| title_short | Typical chest pain and precordial leads ST-elevation in patients with pacemakers - are we always looking at an acute myocardial infarction? |
| title_sort | typical chest pain and precordial leads st elevation in patients with pacemakers are we always looking at an acute myocardial infarction |
| topic | pacemaker, artificial myocardial infarction pericarditis heart conduction system catheterablation diagnosis, differential |
| url | http://www.doiserbia.nb.rs/img/doi/0042-8450/2015/0042-84501500061O.pdf |
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