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Electrocardiographic Findings of Nikus et al Associated with Left Main or Severe Triple Vessel Disease in a Patient with Acute Coronary Syndrome

Purpose: To identify a patient with acute coronary syndrome (ACS) who may have left main or severe triple vessel disease based on changes seen in the ECG.

Description

It is important to identify a patient with left main or severe triple vessel disease since the patient is at high risk for death if there is a sudden obstruction. Nikus et al identified an ECG pattern which can help to recognize such a patient. The authors are from Tampere University Hospital in Finland and Procardia Medical Center in Tel Aviv.


Patient selection: acute coronary syndrome (ACS)

 

Pattern in the ECG:

(1) transient ST-segment depression

(2) negative T waves, with maximal depression seen in lead V4 or V5

 

This pattern correlates with acute circumferential subendocardial ischemia.

 

A patient who shows this pattern on the ECG should be considered for angiography and an intervention to improve coronary perfusion.


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Specialty

Objective

ICD-10