Posterior Myocardial Infarction: Detecting Acute Onset by Left Posterior ECG Leads V7-V10

2.50
Hdl Handle:
http://hdl.handle.net/10755/162587
Type:
Presentation
Title:
Posterior Myocardial Infarction: Detecting Acute Onset by Left Posterior ECG Leads V7-V10
Abstract:
Posterior Myocardial Infarction: Detecting Acute Onset by Left Posterior ECG Leads V7-V10
Conference Sponsor:Emergency Nurses Association
Conference Year:1996
Author:Williams, Mary T., RN
Co-Authors:Mellisa Hannon, RN; Gail Thomason, RN, CEN; and Marc Pollack, MD, PhD
Purpose: An ECG is one of the simplest, most cost effective diagnostic tools for early detection of acute myocardial infarction (MI). However, standard 12-lead ECG placement limits the adequacy of assessing the posterior and right ventricular walls of the heart. A significant amount of patients with right ventricular and interior wall infarctions may also have posterior wall involvement. This study supports the nursing process through assessment and early detection of the posterior MI in order to provide the highest standard of care for our cardiac patients.

Design and Setting: A prospective, descriptive study was conducted at a suburban, level II trauma, teaching hospital emergency department with 56,000 annual visits.

Sample: A random sample in which 500 patients were enrolled with a chief complaint of chest pain and/or related complaints where an ECG was necessary to assess ischemia/infarction.

Methodology: Upon initial patient assessment, intervention, and evaluation of the standard ECG, posterior leads were place. A retrospective chart review confirms the diagnosis of posterior MI by posterior wall motion abnormality via echocardiogram, angiography, and/or nuclear imaging tests.

Results: To date, 342 charts (68%) have been analyzed. Seventy-five had acute MI. Sixteen were diagnosed with posterior MI during their admissions. Nine patients presented with ST elevation in the posterior leads in the emergency department. Of those, seven were confirmed by wall motion changes to have a posterior MI. However, two patients have presented with elevation initially in the emergency department, ruled out secondary to normal wall motion. The remaining seven patients had no posterior ECG changes but tested positive wall motion abnormalities.

Conclusion: Early detection of acute MI, including posterior MI, is necessary if we are to limit the amount of cardiac damage and initiate appropriate interventions. Preliminary data demonstrates positive feedback regarding the utilization of the posterior ECG as an aid in diagnosing the MI patient. However, more research should be pursued to improve the tools available to provide the highest standard of care for our cardiac patients. [Research Poster Presentation]
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titlePosterior Myocardial Infarction: Detecting Acute Onset by Left Posterior ECG Leads V7-V10en_GB
dc.identifier.urihttp://hdl.handle.net/10755/162587-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Posterior Myocardial Infarction: Detecting Acute Onset by Left Posterior ECG Leads V7-V10</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">1996</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Williams, Mary T., RN</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">res@ena.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Mellisa Hannon, RN; Gail Thomason, RN, CEN; and Marc Pollack, MD, PhD</td></tr><tr><td colspan="2" class="item-abstract">Purpose: An ECG is one of the simplest, most cost effective diagnostic tools for early detection of acute myocardial infarction (MI). However, standard 12-lead ECG placement limits the adequacy of assessing the posterior and right ventricular walls of the heart. A significant amount of patients with right ventricular and interior wall infarctions may also have posterior wall involvement. This study supports the nursing process through assessment and early detection of the posterior MI in order to provide the highest standard of care for our cardiac patients.<br/><br/>Design and Setting: A prospective, descriptive study was conducted at a suburban, level II trauma, teaching hospital emergency department with 56,000 annual visits.<br/><br/>Sample: A random sample in which 500 patients were enrolled with a chief complaint of chest pain and/or related complaints where an ECG was necessary to assess ischemia/infarction.<br/><br/>Methodology: Upon initial patient assessment, intervention, and evaluation of the standard ECG, posterior leads were place. A retrospective chart review confirms the diagnosis of posterior MI by posterior wall motion abnormality via echocardiogram, angiography, and/or nuclear imaging tests.<br/><br/>Results: To date, 342 charts (68%) have been analyzed. Seventy-five had acute MI. Sixteen were diagnosed with posterior MI during their admissions. Nine patients presented with ST elevation in the posterior leads in the emergency department. Of those, seven were confirmed by wall motion changes to have a posterior MI. However, two patients have presented with elevation initially in the emergency department, ruled out secondary to normal wall motion. The remaining seven patients had no posterior ECG changes but tested positive wall motion abnormalities.<br/><br/>Conclusion: Early detection of acute MI, including posterior MI, is necessary if we are to limit the amount of cardiac damage and initiate appropriate interventions. Preliminary data demonstrates positive feedback regarding the utilization of the posterior ECG as an aid in diagnosing the MI patient. However, more research should be pursued to improve the tools available to provide the highest standard of care for our cardiac patients. [Research Poster Presentation]</td></tr></table>en_GB
dc.date.available2011-10-27T10:30:42Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:30:42Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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