Key result
Persistent hyperacute T waves in LAD occlusion indicate nearly transmural necrosis, representing a STEMI equivalent.
Why the study?
What are the underlying myocardial tissue changes on cardiac magnetic resonance in patients with acute myocardial infarction presenting with persistent hyperacute T waves?
Observational
What are the underlying myocardial tissue changes on cardiac magnetic resonance in patients with acute myocardial infarction presenting with persistent hyperacute T waves?
Persistent hyperacute T waves should be regarded as an equivalent to ST-segment elevation myocardial infarction (STEMI) and prompt immediate consideration for reperfusion therapy, as CMR reveals underlying transmural necrosis.
Answers are grounded in this paper and cite their sources.
May support urgent reperfusion for persistent hyperacute T waves; hypothesis-generating and requires prospective validation.
Peaked and tall T waves represent a hyperacute electrocardiogram (ECG) manifestation of coronary artery occlusion which usually evolves into ST-segment elevation. We sought to investigate using cardiac magnetic resonance (CMR) the myocardial tissue changes underlying an atypical ECG pattern of presentation of left anterior descending artery (LAD) occlusion consisting of persistent hyperacute T waves and mild ST-segment depression. This ECG pattern is often associated with the presence of collateral circulation, which may modulate myocyte action potential changes in response to ischemia and prevent the appearance of ST-segment elevation. However, CMR findings resembled those of typical anterior myocardial infarction with nearly transmural necrosis in the large myocardial area supplied by LAD. Accordingly, persistent hyperacute T waves should be regarded as an equivalent to ST-segment elevation and immediate reperfusion therapy should be considered.
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Zorzi et al. (2012) conducted an observational in Acute myocardial infarction with persistent hyperacute T waves. Cardiac magnetic resonance (CMR) was evaluated on Myocardial tissue changes. Cardiac magnetic resonance demonstrated that persistent hyperacute T waves in LAD occlusion indicate nearly transmural necrosis, suggesting they should be treated as an ST-segment elevation equivalent.
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