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Characteristic electrocardiographic pattern indicating a critical stenosis high in left anterior descending coronary artery in patients admitted because of impending myocardial infarction

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Professor Hein J.J. Wellens

Abstract

In patients admitted to the hospital because of unstable angina, a subgroup can be recognized that is at high risk for the development of an extensive anterior wall myocardial infarction. These patients, who show characteristic ST-T segment changes in the precordial leads on or shortly after admission, have a critical stenosis high in the left anterior descending coronary artery. Of 145 patients consecutively admitted because of unstable angina, 26 (18%) showing this ECG pattern, suggesting that this finding is not rare. In spite of symptom control by nitroglycerin and beta blockade, 12 of 16 patients (75%) who were not operated on developed an usually extensive beta blockade, 12 of 16 patients (75%) who were not operated on developed a usually extensive anterior wall infarction within a few weeks after admission. In view of these observations, urgent coronary angiography and, when possible, coronary revascularization should be done in patients with unstable angina who show this ECG pattern.

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J. L. R. M. Smeets P. A. Doevendans M. E. Josephson Ch. Kirchhof M. A. Vos

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© 2000 Springer Science+Business Media Dordrecht

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De Zwaan, C., Bär, F.W.H.M., Wellens, H.J.J. (2000). Characteristic electrocardiographic pattern indicating a critical stenosis high in left anterior descending coronary artery in patients admitted because of impending myocardial infarction. In: Smeets, J.L.R.M., Doevendans, P.A., Josephson, M.E., Kirchhof, C., Vos, M.A. (eds) Professor Hein J.J. Wellens. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-4110-9_23

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  • DOI: https://doi.org/10.1007/978-94-011-4110-9_23

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-5799-8

  • Online ISBN: 978-94-011-4110-9

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