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Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 245))

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Conclusion

While Troponin determination will document loss of myocardial tissue in unstable angina the standard 12 lead ECG gives important information about the site and extent of ischemia. It is possible to identify high risk situations such as unstable angina due to a proximal LAD lesion or caused by either 3 vessel disease or left main stem stenosis. Recognizing these entities is important for decision making to restore adequate patency in the culprit vessel(s).

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References

  1. Antman EM, Cohen M, Bernink PJ et al. The TIMI risk score for unstable angina from ST elevation MI: a method for prognosticitation and therapeutic decision making. JAMA 2000; 284:835–842.

    Article  PubMed  CAS  Google Scholar 

  2. Kaul P, Fu Y, Shang WC, et al. Prognostic value of ST segment depression in acute coronary syndromes: insights from PARAGON-A appliedto GUSTO-II b. J Am Coll Cardiol 2001;38:64–71.

    Article  PubMed  CAS  Google Scholar 

  3. Savonitto S, Ardissino D, Granger CB, et al. Prognostic value of the admission electrocardiogram in acute coronary syndromes. JAMA 1999;281:707–713.

    Article  PubMed  CAS  Google Scholar 

  4. Hyde TA, French JK, Wong CK, et al. Four-year survival of patients with acute coronary syndromes without ST-segment elevation and prognostic significance of 0,5 mm ST-segment depression. Am J Cardiol 1999;84:379–385.

    Article  PubMed  CAS  Google Scholar 

  5. Solomon DH, Stone PH, Glynn RJ, et al. Use of risk stratification to identify patients with unstable angina likeliest to benefit from an invasive versus conservative management strategy. J Am Coll Cardiol 2001;38:969–976.

    Article  PubMed  CAS  Google Scholar 

  6. Didenholm E, Andren B, Frostfeldt G, et al. ST depression in ECG at entry indicates severe coronary lesions and large benefits of an early invasive treatment strategy in unstable coronary artery disease. Eur Heart J 2002;23:41–49.

    Google Scholar 

  7. Widdershoven JW, Gorgels AP, Vermeer F, et al. Changing characteristics and in-hospital outcome of patients admitted with acute myocardial infarction. Observations from 1982–1994. Eur Heart J 1997;1073–1080.

    Google Scholar 

  8. Klootwijk P, Mey S, Van Es GA, et al. Comparison of usefulness of computer-assisted continuous hour 3-lead with 12-lead ECG-ischemia monitoring for detection and quantification of ischemia in patients with unstable angina. Eur Heart J 1997; 18: 931–940.

    PubMed  CAS  Google Scholar 

  9. Akkerhuis KM, Klootwijk PAJ, Lindeboom W, et al. Recurrent ischemia during continuous multilead ST-segment monitoring identifies patients with acute coronary syndromes at high risk of adverse cardiac events. Eur Heart J 2001; 22:1997–2006.

    Article  PubMed  CAS  Google Scholar 

  10. De Zwaan C, Bar FW, Wellens HJ. Characteristic electrocardiographic pattern indicating a critical stenosis high in left anterior descending coronary artery in patients admitted because of impending myocardial infarction. Am Heart J 1982;103:730–735.

    PubMed  Google Scholar 

  11. De Zwaan C, Bar FW, Gorgels AP, Wellens HJ. Unstable angina: are we able to recognize high-risk patients? Chest 1997;112:224–50.

    Google Scholar 

  12. Gorgels APM, Vos MA, Mulleneers R, de Zwaan C, Bar FW, Wellens HJ. Value of the electrocardiogram in diagnosing the number of severely narrowed coronary arteries in rest angina pectoris. Am J Cardiol 1993;72:999–1003.

    Article  PubMed  CAS  Google Scholar 

  13. Fozzard HA, Makielski JC. The electrophysiology of acute myocardial ischemia. Annual review of medicine 1985;36:275–280.

    Article  PubMed  CAS  Google Scholar 

  14. Simon K, Hackett D, Szelier A, et al. The natural history of postischemic T wave inversion: a predictor of poor short-term prognosis? Coronary Artery Disease 1994;5:937–942.

    PubMed  CAS  Google Scholar 

  15. Shawl FA, Velasco CE, Goldbaum TS, Forman BM. Effect of coronary angioplasty on electrocardiographic changes in patients with unstable angina secondary to left anterior descending coronary artery disease. J Am Coll Cardiol 1990;16:325–331.

    Article  PubMed  CAS  Google Scholar 

  16. De Zwaan C, Bar FW, Janssen JH, et al. Angiographic and clinical characteristics of patients with unstable angina showing an ECG pattern indicating critical narrowing of the proximal LAD coronary artery. Am Heart J. 1989;117:657–666.

    PubMed  Google Scholar 

  17. Agetsuma H, Hirai M, Hirayama H, et al. Transient giant negative T-wave in acute anterior wall infarction predicts R-waverecovery and preservation of left ventricular dysfunction. Heart 1996;75:229–234.

    PubMed  CAS  Google Scholar 

Download references

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© 2002 Kluwer Academic Publishers

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(2002). The electrocardiogram in unstable angina. In: The ECG in Acute Myocardial Infarction and Unstable Angina. Developments in Cardiovascular Medicine, vol 245. Springer, Boston, MA. https://doi.org/10.1007/0-306-48202-9_7

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  • DOI: https://doi.org/10.1007/0-306-48202-9_7

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4020-7214-7

  • Online ISBN: 978-0-306-48202-1

  • eBook Packages: Springer Book Archive

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