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The use of additional ECG leads like right-sided leads V3R and V4R and posterior leads V7, V8, and V9 may improve sensitivity for right ventricular and posterior myocardial infarction. In spite of these limitations, the 12 lead ECG stands at the center of risk stratification for the patient with suspected acute myocardial infarction.
In particular, acute myocardial infarction in the distribution of the circumflex artery is likely to produce a nondiagnostic ECG. [10] The use of additional ECG leads like right-sided leads V3R and V4R and posterior leads V7, V8, and V9 may improve sensitivity for right ventricular and posterior myocardial infarction. [citation needed]
Anticoagulants: To prevent embolization.. Beta blockers: To block the effects of certain hormones on the heart to slow the heart rate.. Calcium Channel Blockers: Help slow the heart rate by blocking the number of electrical impulses that pass through the AV node into the lower heart chambers (ventricles).
Electrocardiography is the process of producing an electrocardiogram (ECG or EKG [a]), a recording of the heart's electrical activity through repeated cardiac cycles. [4] It is an electrogram of the heart which is a graph of voltage versus time of the electrical activity of the heart [ 5 ] using electrodes placed on the skin.
12-lead electrocardiogram showing ST-segment elevation (orange) in I, aVL and V1–V5 with reciprocal changes (blue) in the inferior leads, indicative of an anterior wall myocardial infarction. When there is a blockage of the coronary artery, there will be lack of oxygen supply to all three layers of cardiac muscle (transmural ischemia).
Bifascicular block is a combination of right bundle branch block and either left anterior fascicular block or left posterior fascicular block. Conduction to the ventricle would therefore be via the remaining fascicle. The ECG will show typical features of RBBB plus either left or right axis deviation. [7] [8]
The ECG will show a terminal R wave in lead V1 and a slurred S wave in lead I. Left bundle branch block widens the entire QRS, and in most cases shifts the heart's electrical axis to the left. The ECG will show a QS or rS complex in lead V1 and a monophasic R wave in lead I.
This has been used for the risk stratification of sudden cardiac death in people who have had a myocardial infarction, as well as in people with known coronary heart disease, cardiomyopathies, or unexplained syncope. Still, the real predictive value of these findings is questioned. Late potentials may be found in 0-10% of normal volunteers.
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