Does EKG Favor a Correct Localization of the Ischemic Areas?
Ischemic heart disease (IHD) is the most common cause of death worldwide and its prevalence is increasing. The electrocardiogram (EKG) is a fundamental diagnostic tool in the setting of suspected myocardial ischemia. Ischemia produces complex changes in the EKG, involving the QRS complex and, mostly, the repolarization phase (ST-segment). In this chapter we will review the basic mechanisms underlying these EKG changes, focusing on the theories of diastolic and systolic currents of injury. Furthermore, starting from clinical cases, we will try to give the clinician practical and useful tips for the correct interpretation of the EKG in order to identify the area of the myocardium involved by ischemia, the occluded coronary artery and also to capture prognostic information. Our final goal is being to improve patient management and help choosing the most appropriate therapy.
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