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J Korean Soc Emerg Med > Volume 15(3); 2004 > Article
Journal of The Korean Society of Emergency Medicine 2004;15(3): 184-192.
Myocardial Infarction: Comparison of 12-Lead Electrocardiographic Criteria with 80-Lead Body Surface Mapping
Won Young Kim, Won Kim, Bum Jin Oh, Se Hyun Oh, Kyoung Soo Lim
1Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, seoul, Korea. wkim@amc.seoul.kr
2Gang Nung Asan Hospital, Gangnung, Korea.
Right ventricular (RV) infarction is associated with increased morbidity and mortality in patients with acute inferior wall myocardial infarction (MI). A 12-lead electrocardiogram (ECG) has a poor tendency to identify RV involvement. Our objective was to evaluate the diagnostic accuracy of 80-lead body surface mapping (BSM) for RV infarction and to compare diagnostic accuracy of 12-lead ECG criteria and 80-lead BSM for RV infarction in patients with acute inferior wall MI.
Between September 2002 and January 2003, 96 patients visited to our emergency center with AMI. All standard initial 12-lead ECG and 80-lead BSM were examined and compared with angiographic and echocardiographic findings.
Thirty-one patients were confirmed as inferior wall MI. With the use of exclusion criteria, sixteen patients included in this study. RV infarction accompanied in 5 patients of these 16 patients. BSM showed a high sensitivity (60%), specificity (82%), high positive and negative predictive values (60%, and 82%, respectively), and high diagnostic accuracy (75%) in diagnosing RV infarction in patients with acute inferior wall MI. BSM showed increase in the sensitivity for RV infarction from 40% to 60% when compared with the 12-lead ECG.
The 80-lead BSM is a more useful test in diagnosing RV infarction in patients with acute inferior wall
Key words: Myocardial infarction, Right ventricle, Body surface mapping
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