Chest
CommentaryMechanism and Time Course of the Early Electrical Changes During Acute Coronary Artery Occlusion: An Attempt to Correlate the Early ECG Changes in Man to the Cellular Electrophysiology in the Pig
Section snippets
Case Report
A 41-year-old diabetic man was admitted to the Ciudad Sanitaria de Barcelona because of two successive episodes of chest pain four hours previously. They were related to minimal exercise and lasted 2 and 20 minutes respectively. On admission, the ECG showed normal sinus rhythm with slight ST-segment depression (1 to 2 mm) in leads 2, 3, and aVF. The T waves were positive and symmetrical in leads V3 to V5. Serum glutamic oxaloacetic transaminase (SGOT) value was 32, creatine Phosphokinase (CPK)
Discussion
It has been established long ago that “injury” to the heart, usually by locally applying concentrated potassium chloride solutions to the epicardium, resulted in “elevation” of the ST segment, which in reality, was due to a depression of the baseline.5, 6, 7 More recent studies4 and the present report show that in acute myocardial ischemia, the ST elevation as recorded with AC-coupled amplifiers is, in fact, caused by a combination of depression of the TQ segment and true elevation of the ST
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Manuscript received February 15; revision accepted July 2.