Tombstone ST elevation: Difference between revisions
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==Overview== | ==Overview== | ||
Tombstone [[ST elevation]] is | Tombstone [[ST elevation]] is an electrocardiographic pattern of [[ST segment elevation]] whereby the [[QRS]] complex, the [[ST segment]] and the [[T wave]] merge to form a large upright monophasic deflection called a "tombstone"<ref>Wimalaratna HS. “Tombstoning” of ST segment in acute myocardial infarction. Lancet 1993; 342 (8869): 496.</ref><ref>Guo XH, Yap YG, Chen LJ, et al. Correlation of coronary angiography with “tombstoning” electrocardiographic pattern in patients after acute myocardial infarction. Clin Cardiol 2000; 23: 347-52.</ref><ref>Balci B, Yesildag O. Correlation between clinical findings and the “tombstoning” electrocardiographic pattern in patients with anterior wall acute myocardial infarction. Am J Cardiol 2003; 92: 1316-8.</ref><ref>Birnbaum Y, Sclarovsky S. “Tombstoning” of ST segment in acute myocardial infarction. Lancet 1993; 342: 1494.</ref>. This electrocardiographic pattern has been associated with poorer clinical outcomes in the setting of [[ST segment elevation myocardial infarction]]. | ||
==Criteria== | ==Criteria== | ||
#The [[R wave]] is absent or its duration is <0.04 seconds with minimal amplitude; | #The [[R wave]] is absent or its duration is <0.04 seconds with minimal amplitude; | ||
#The [[ST segment]] is convex upward and merges with the descending limb of the [[R wave]] or the ascending limb of the QS wave; | #The [[ST segment]] is convex upward and merges with the descending limb of the [[R wave]] or the ascending limb of the [[QS wave]]; | ||
#The peak of the convex ST segment is higher than whatever remains of the R wave; and | #The peak of the convex [[ST segment]] is higher than whatever remains of the [[R wave]]; and | ||
#The convex ST segment merges with the ascending limb of the T wave. | #The convex ST segment merges with the ascending limb of the [[T wave]]. | ||
==Example== | |||
[[Image:Tombstone ekg.jpg|400|Source:http://pradubsukhum.com/ECG/MI/MI%20tables/Evolving%20ST%20T%20abnormalities%20in%20acute%20ST%20elevation%20MI.html ]] | |||
Source: http://pradubsukhum.com/ECG/MI/MI%20tables/Evolving%20ST%20T%20abnormalities%20in%20acute%20ST%20elevation%20MI.html | |||
==References== | ==References== | ||
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[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:Up-To-Date]] | [[Category:Up-To-Date]] | ||
[[Category:Up-To-Date | [[Category:Up-To-Date cardiology]] | ||
Latest revision as of 21:09, 22 November 2011
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Tombstone ST elevation is an electrocardiographic pattern of ST segment elevation whereby the QRS complex, the ST segment and the T wave merge to form a large upright monophasic deflection called a "tombstone"[1][2][3][4]. This electrocardiographic pattern has been associated with poorer clinical outcomes in the setting of ST segment elevation myocardial infarction.
Criteria
- The R wave is absent or its duration is <0.04 seconds with minimal amplitude;
- The ST segment is convex upward and merges with the descending limb of the R wave or the ascending limb of the QS wave;
- The peak of the convex ST segment is higher than whatever remains of the R wave; and
- The convex ST segment merges with the ascending limb of the T wave.
Example
References
- ↑ Wimalaratna HS. “Tombstoning” of ST segment in acute myocardial infarction. Lancet 1993; 342 (8869): 496.
- ↑ Guo XH, Yap YG, Chen LJ, et al. Correlation of coronary angiography with “tombstoning” electrocardiographic pattern in patients after acute myocardial infarction. Clin Cardiol 2000; 23: 347-52.
- ↑ Balci B, Yesildag O. Correlation between clinical findings and the “tombstoning” electrocardiographic pattern in patients with anterior wall acute myocardial infarction. Am J Cardiol 2003; 92: 1316-8.
- ↑ Birnbaum Y, Sclarovsky S. “Tombstoning” of ST segment in acute myocardial infarction. Lancet 1993; 342: 1494.