Acute Coronary Syndromes and Cardiac Function Testing

Electrocardiographic Findings in Acute Coronary Syndromes

Acute coronary syndromes (ACS) encompass a spectrum of conditions associated with acute myocardial ischemia, including unstable angina, non-ST-elevation myocardial infarction (NSTEMI), and ST-elevation myocardial infarction (STEMI). One of the key diagnostic tools for ACS is electrocardiography (ECG), which helps determine the presence and extent of myocardial damage.

ECG Changes in Acute Coronary Syndromes

• ST-Elevation Myocardial Infarction (STEMI): Characterized by persistent ST-segment elevation in at least two contiguous leads, indicative of complete coronary artery occlusion.
• Non-ST-Elevation Myocardial Infarction (NSTEMI): Presents with ST-segment depression, T-wave inversions, or non-specific changes.
• Unstable Angina: ECG may appear normal or show subtle ST-segment or T-wave abnormalities.

Additional ECG Findings

• Pathologic Q-waves suggest irreversible myocardial necrosis.
• Hyperacute T-waves may be an early indicator of ischemia.
• Reciprocal changes in ST segments can indicate ischemic regions.

Role of ECG in Risk Stratification

ECG findings play a pivotal role in assessing patient prognosis, guiding therapeutic decisions, and determining urgency for interventions such as reperfusion therapy.