AMI Normalization after Angioplasty Criteria - Medical Algorithm

Description

van't Hof et al gave criteria for the degree of normalization of ST segment elevation following primary angioplasty in a patient with an acute myocardial infarction. This correlates with prognosis for the patients. The authors are from the Zwolle Myocardial Infarction Study in Zwolle, The Netherlands.

Exclusion: new bundle branch block, ventricular pacemaker, sustained idioventricular rhythm

Timing of 12-lead ECG: on admission and 1 hour after primary angioplasty

The leads used to determine the ST segment elevation for the patient depended on the location of the infarction (anterior vs non-anterior):

Leads Summated for an Anterior AMI	Leads Summated for a Non-Anterior AMI
I	II
aVL	III
V1	aVF
V2	V5
V3	V6
V4
V5
V6

total ST segment elevation =

= SUM(elevation in ST segment from baseline)

percent decrease in total ST segment elevation =

= 100% * (1 - ((total ST segment after angioplasty) / (total ST segment before)))

residual ST segment elevation =

= ((total ST segment after angioplasty) / (total ST segment before))

Criteria	ST Segment Elevation	Interpretation
no residual ST segment elevation >= 0.1 mV in any lead	complete resolution	normalized
residual ST segment elevation after therapy < 70% of initial elevation	partial resolution	improved
residual ST segment elevation after therapy >= 70% of initial elevation	no resolution	unchanged

ST Segment Elevation	Relative Risk for Death	95% CI
complete resolution	1.0
partial resolution	3.6	1.6 to 8.3
no resolution	8.7	3.7 to 20.1

To read more or access our algorithms and calculators, please log in or register.

Description

Specialty

Objective

ICD-10

Acute Myocardial Infarction (AMI) Normalization Criteria after Angioplasty

Purpose: To determine if reperfusion has occurred after primary angioplasty in a patient with an acute MI using the sum of ST segment elevations.

Description

Specialty

Objective

ICD-10