STEMI-Äquivalente im EKG – eine fallbasierte Darstellung

Abstract

The 12-lead resting ECG remains an indispensable diagnostic tool in patients with acute chest pain. This is particularly important as the identification of ST-segment elevations leads to the diagnosis of ST-segment elevation myocardial infarction (STEMI) and subsequent, immediate coronary reperfusion (usually via primary PCI). However, correct interpretation of the 12-lead ECG in patients with acute chest pain remains challenging. Apart from “classical” ST-segment elevations there are several “equivalents” in the ECG pointing towards an acute coronary occlusion. Among these, hyperacute T-waves, subtle ST-segment elevations, ST-segment elevation in leads aVR/V₁ with concomitant ST-segment depression in ≥ 8 other leads and high R-peak with positive T-waves combined with horizontal ST-segment depression in leads V₁/V₂ can be found. This article provides a case-based presentation of STEMI equivalents on the ECG in order to improve correct ECG interpretation and prognosis of such patients.

Bei Patienten mit Verdacht auf einen Myokardinfarkt zählt das 12-Kanal-Ruhe-EKG zu einer unverzichtbaren Basisdiagnostik. Eine besonders wichtige Bedeutung hat dabei das Erkennen von ST-Streckenhebungen, das zu einer sofortigen koronaren Revaskularisation führen sollte. Darüber hinaus gibt es STEMI-Äquivalente im EKG, deren Darstellung Gegenstand dieser Arbeit ist.

Schlüsselwörter

Myokardinfarkt - STEMI - EKG - Interpretation

Key words

myocardial infarction - STEMI - ECG - interpretation

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