M.M. MANGUSHEVA¹, S.D. MAYANSKAYA¹, G.G. ISKHAKOVA²

¹Kazan State Medical University, Kazan

²Hospital for War Veterans of the city of Kazan, Kazan

Contact details:

Mayanskaya S.D. ― D. Sc. (medicine), Professor of the Department of Hospital Therapy

Address: 49 Butlerova St., Kazan, Russian Federation, 420012, e-mail: Smayanskaya@mail.ru

The problems of diagnosing acute myocardial infarction (MI) are due to delay in ECG late changes, presence of non-specific signs characteristic of many conditions that are not associated with ischemic heart disease (IHD). The article presents the most frequent difficulties of ECG interpretation of myocardial infarction. They can be a variant of a normal ECG, reflect non-coronary myocardial changes, serve as a reflection of acute coronary pathology requiring emergency treatment, or be the result of secondary changes in blockade of the His bundle branch, WPW syndrome, LV hypertrophy, etc., as well as associated with localization of MI or its recurrent course. It is noted that in the early stages of the disease, with an appropriate clinical picture, it is possible to suspect IM on ECG: the appearance of both negative and positive dynamics compared with previous ECG, high pointed T teeth, reciprocal changes, conduction rhythm disturbances; registration of additional ECG leads, as well as long-term monitoring of ECG with total block of the His bundle branch or ventricular preexposure syndrome. In case of difficulty of interpretation, it is necessary to take into account the data of the clinical picture and additional diagnostic methods.

Key words: ECG, myocardial infarction, STsegment elevation, ST segment depression, infarction-like changes, difficulties in ECG interpretation.

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