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m (New page: {{Chapter|Myocardial Infarction}} In approximately 10% of the infractpatients, atrial infarct is suspected. An atrial infarct can manifest itself in atrial rhytmdisturbances: atrial fibril...) |
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{{Chapter|Myocardial Infarction}} | {{Chapter|Myocardial Infarction}} | ||
In approximately 10% of | In approximately 10% of infarctpatients, atrial infarct is suspected. An atrial infarct can manifest itself in atrial rhytmdisturbances: atrial fibrillation / atrial rhythm. Because the atria are hemodynamically of minor importance, the consequences of an atrial infarct are limited (and therfore often missed!). | ||
On the ECG, an atrial infarct manifests by | On the ECG, an atrial infarct manifests by rhythm changes and/or change of the [[PTa segment|P-Ta segment]] (sometimes called PTA (''P'' - ''a''triale ''T'') segment or PR or PQ or PTp (''P'' - ''T'' wave of ''P'' wave) segment)<cite>Abildskov</cite>. This is the part between the end of the P wave and the Q. The ST segment indicates an infarct in the ventricle, the P-Ta segment indicates an infarct in the atria. | ||
Diagnostic criteria for an atrial infarct <cite>Liu</cite>: | Diagnostic criteria for an atrial infarct <cite>Liu</cite>: | ||
* P-Ta elevation >0.5mm in V5 and V6 with reciprocal depression in V1 and V2 | * P-Ta elevation >0.5mm in V5 and V6 with reciprocal depression in V1 and V2 | ||
* P-Ta elevation >0.5mm in I and depression in II and III | * P-Ta elevation >0.5mm in I and depression in II and III | ||
* >1.5mm P-Ta depression in precordial leads | * > 1.5mm P-Ta depression in precordial leads | ||
* >1.2mm P-Ta depression in I,II or III in combination with atrial arrhytmias | * > 1.2mm P-Ta depression in I,II or III in combination with atrial arrhytmias | ||
Several diagnostic criteria are in use, and this is just an example of one. An important differential diagnosis of PTa segment elevation or depression is pericarditis. | Several diagnostic criteria are in use, and this is just an example of one. An important differential diagnosis of PTa segment elevation or depression is pericarditis. | ||
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<biblio> | <biblio> | ||
#Abildskov pmid=13649561 | #Abildskov pmid=13649561 | ||
#Liu pmid=13762787 | |||
</biblio> | </biblio> |