SPECIFIC FINDINGS OF THE STANDARD 12-LEADELECTROCARDIOGRAM IN PATIENTS WITH TRANSIENTLEFT VENTRICULAR APICAL BALLOONING: COMPARISONWITH ANTERIOR AMI

摘要

Background: Transient left ventricular apical ballooning is very unique disease mimicking acute myocardial infarction (AMI) in patients with normal findings on coronary angiogram (CAG)-Circulation.2003;108:2014. Because the ECG findings of this disease are similar to those seen with anterior AMI, emergent CAG is usually performed. Object: The aim of this study was to determine whether the standard 12-lead ECG could distinguish Transient left ventricular apical ballooning (groupA) from anterior AMI (groupB). Method and result: The ECG findings of two groups (n=26) were compared in acute phase. No reciprocal changes were seen in patients with group A (p=0.0003). The ratio of ST-segment elevations in leads V4-V6 to V1-V3 (STeV4-6/Vl-3) was significantly higher in patients with group A (1.55+-0.53 vs. 0.57+-0.58, p=0.0004). The QTc interval was significantly longer in patients with group A. Although QT dispersion was increased in both groups, the degree of dispersion was greater in patients with group A (101+-30 vs. 63+-16 ms, p=0.0006). Furthermore, the combination of the absence of reciprocal changes and STeV4-6/Vl-3>l had a greater specificity (100%) and overall accuracy (91%) than either criteria. Conclusion: The standard 12-lead ECG on admission can accurately distinguish Transient left ventricular apical ballooning from anterior AMI.