Sgarbossa E B, Birnbaum Y, Parrillo J E
Section of Cardiology, Rush Presbyterian-St. Luke's Medical Center, 1750 W. Harrison St., Chicago, IL 60612, USA.
Am Heart J. 2001 Apr;141(4):507-17. doi: 10.1067/mhj.2001.113571.
Over the past 2 decades, the 12-lead electrocardiogram has attained special significance for the diagnosis and triage of patients with chest pain because timely detection of myocardial injury and a rapid assessment of myocardium at risk proved pivotal to implementing effective reperfusion therapies during acute myocardial infarction. However, this wealth of information could still be underutilized by clinicians who may restrict their diagnostic quest in patients with chest pain to the more classic electrocardiographic signs.
The medical literature on electrocardiographic manifestations of acute myocardial infarction was extensively reviewed.
The widespread utilization of both coronary angiography and methods to determine myocardial function and metabolism in patients with acute myocardial infarction over the last 10 years has provided the means for rigorous comparisons with electrocardiographic information. We summarize these electrocardiographic signs and patterns in terms of their relevance to the clinician to help reduce the incidence of "nondiagnostic electrocardiograms" and improve timely decision-making.
The electrocardiogram continues to be an invaluable tool in the initial evaluation of patients with chest pain. The plethora of data currently available on electrocardiographic changes correlating with myocardial injury allows clinicians to make faster and better decisions than ever before.
在过去20年中，12导联心电图对于胸痛患者的诊断和分诊具有特殊意义，因为及时检测心肌损伤并快速评估有风险的心肌对于在急性心肌梗死期间实施有效的再灌注治疗至关重要。然而，临床医生可能仍未充分利用这些丰富的信息，他们在胸痛患者中的诊断探索可能局限于更经典的心电图体征。
广泛回顾了关于急性心肌梗死心电图表现的医学文献。
在过去10年中，冠状动脉造影以及测定急性心肌梗死患者心肌功能和代谢的方法的广泛应用，为与心电图信息进行严格比较提供了手段。我们根据这些心电图体征和模式与临床医生的相关性进行总结，以帮助减少“非诊断性心电图”的发生率并改善及时决策。
心电图仍然是胸痛患者初始评估中非常宝贵的工具。目前可获得的大量与心肌损伤相关的心电图变化数据使临床医生能够比以往更快、更好地做出决策。
