Journal of Emergencies, Trauma, and Shock

CASE REPORT
Year
: 2022  |  Volume : 15  |  Issue : 1  |  Page : 66--69

Early/Subtle electrocardiography features of acute coronary syndrome and ST-Segment elevation myocardial infarction


R Gunaseelan, M Sasikumar, B Nithya, K Aswin, G Ezhilkugan, SS Anuusha, N Balamurugan, M Vivekanandan 
 Department of Emergency Medicine, Jawarharlal Institute of Postgraduate Medical Education and Research, Puducherry, India

Correspondence Address:
Dr. R Gunaseelan
Department of Emergency Medicine, Jawarharlal Institute of Postgraduate Medical Education and Research, Puducherry
India

Chest pain is one of the most common presenting complaints in the emergency department. Interpreting a 12-lead electrocardiography (ECG) for evidence of ischemia is always challenging. Frank ECG changes such as ST-segment elevation and ST-segment depression can be easily identified by emergency physicians. However, identifying subtle or early features of ACS in the 12-lead ECG is essential in preventing significant mortality and morbidity from ACS. In the following case series, we describe five of the subtle/early ECG changes of ACS, namely (1) T-wave inversion in lead aVL; (2) terminal QRS distortion; (3) hyperacute T-waves; (4) negative U-waves in precordial leads; and (5) loss of precordial T-wave balance. In all these cases, the initial 12-lead ECG showed only subtle/early ECG changes which were followed up with serial ECGs which progressed to STEMI.


How to cite this article:
Gunaseelan R, Sasikumar M, Nithya B, Aswin K, Ezhilkugan G, Anuusha S S, Balamurugan N, Vivekanandan M. Early/Subtle electrocardiography features of acute coronary syndrome and ST-Segment elevation myocardial infarction.J Emerg Trauma Shock 2022;15:66-69


How to cite this URL:
Gunaseelan R, Sasikumar M, Nithya B, Aswin K, Ezhilkugan G, Anuusha S S, Balamurugan N, Vivekanandan M. Early/Subtle electrocardiography features of acute coronary syndrome and ST-Segment elevation myocardial infarction. J Emerg Trauma Shock [serial online] 2022 [cited 2022 Aug 15 ];15:66-69
Available from: https://www.onlinejets.org/article.asp?issn=0974-2700;year=2022;volume=15;issue=1;spage=66;epage=69;aulast=Gunaseelan;type=0