Coronary heart disease electrocardiogram: Difference between revisions
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* Resting abnormalities of [[ST segment]] and [[T waves]] | * Resting abnormalities of [[ST segment]] and [[T waves]] | ||
In patients with left bundle branch block the following are recommendations. | In patients with '''left bundle branch block''' the following are recommendations. | ||
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| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | | colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | ||
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| bgcolor="LightGreen"| | | bgcolor="LightGreen"|'''1.''' Pharmacologic myocardial perfusion imaging is preferred. | ||
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|colspan="1" style="text-align:center; background:LightCoral"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]] (No Benefit) | |colspan="1" style="text-align:center; background:LightCoral"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]] (No Benefit) | ||
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|bgcolor="LightCoral"| | |bgcolor="LightCoral"| '''1.''' Exercise myocardial perfusion imaging is not recommended. | ||
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| colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa/b]] | | colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa/b]] | ||
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|bgcolor="LemonChiffon"| | |bgcolor="LemonChiffon"|'''1.''' Stress echocardigoraphy may be used. | ||
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===Prognostic Markers: Exercise EKG=== | ===Prognostic Markers: Exercise EKG=== | ||
Revision as of 14:08, 23 October 2012
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Coronary heart disease Microchapters |
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Coronary heart disease electrocardiogram On the Web |
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American Roentgen Ray Society Images of Coronary heart disease electrocardiogram |
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Risk calculators and risk factors for Coronary heart disease electrocardiogram |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Stress testing is used for risk stratification and diagnosis of coronary artery disease.
Electrocardiogram
Exercise EKG is preferred initial test unless the patients have uninterpretable EKG not in a condition to exercise. Few uninterpretable EKG conditions are
- WPW syndrome
- > 1 mm of ST depression at rest
- Left bundle branch block
- Ventricular pacing
- Resting abnormalities of ST segment and T waves
In patients with left bundle branch block the following are recommendations.
| Class I |
| 1. Pharmacologic myocardial perfusion imaging is preferred. |
| Class III (No Benefit) |
| 1. Exercise myocardial perfusion imaging is not recommended. |
| Class IIa/b |
| 1. Stress echocardigoraphy may be used. |
Prognostic Markers: Exercise EKG
- In ECG recording
- Maximum ST elevation
- Number of leads showing changes
- Duration for onset of ST segment changes
- Duration for ST segment change recovery
- ST/HR indices
- Occurrence exercise induced ventricular arrhythmia
- Hemodynamic markers
- Maximum heart rate, blood pressure, RPP
- Exertional hypotension
- Chronotropic incompetence
- Heart rate recovery
- Exercise capacity
- Duration
- Workload
- Ischemia
- Angina
- Time of onset