Aravind, R (2023) A Study on the Correlation of QRS Amplitude in ECG in ST Elevated Myocardial Infarction to its Outcome and Extent of Vessel Involvement in Coronary Angiogram. Masters thesis, Kilpauk Medical College, Chennai.
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Abstract
INTRODUCTION: Myocardial infarction is one of the most frequently encountered reasons for hospital admission and is commonly seen in all populations worldwide. Theoretically, infarction of the myocardial muscle can be detected based on certain pathological features like coagulation necrosis, causing the loss of muscle cells (myocytes). When such a pathological change occurs, it triggers inflammation, leading to fibrosis and healing with a scar. The 12-lead electrocardiogram is one of the essential diagnostic factors that can be used to detect acute coronary syndrome (ACS). The clinical approach to a patient suspected of acute coronary syndrome consists of detailed history taking, electrocardiogram (ECG) changes, cardiac biochemistry evidence and imaging. The reliability of each of these modalities as a diagnostic tool depends on multiple factors, the most significant being the window period between the infarction and the time the patient seeks medical attention. The current approach to patients presenting with typical or atypical features of myocardial ischemia or infarction starts with making the provisional diagnosis of the acute coronary syndrome. Then, depending on the changes seen on the twelve lead ECG, the acute coronary syndrome is classified into ST-elevation myocardial infarction (STEMI) or non-ST-elevation myocardial infarction (NSTEMI). ST-elevation myocardial infarction (STEMI) is a clinical syndrome characterised by the symptoms of ischemia in correlation with the persistent electrographic ST-elevation (STE) and subsequent release of biomarkers of myocardial necrosis. STE elevations have been significant for detecting acute coronary artery occlusion with collateral circulation, which can be used to assess myocardial injury and infarction that requires immediate reperfusion therapy. OBJECTIVE: PRIMARY OBJECTIVE: To assess the value of QRS amplitude in STEMI patients as a prognostic indicator with the extent of Vessel involvement in coronary angiogram. SECONDARY OBJECTIVES: 1. To assess outcome in terms of ECHO findings with respect to Ejection fraction. 2. To assess Age and Sex distribution. 3. To assess correlation with respect to Smoking, Alcoholism, Comorbidites - Diabetes and Hypertension. METHOD: Study design: Comparative study. Period of Study: May 2022 to November 2022. Duration of Study: 6 months. Place of Study: Government Royapettah Hospital, Chennai-600 014 and Government Kilpauk Medical College, Chennai – 600 010. RESULT: Our study reports significant differences in the QRS amplitude with a correlation between Ejection Fraction (EF%) and vessel obstruction. The comparison yielded with Pearson correlation stated a sig. (2-tailed) value of 0.031 for EF% and a significant difference with vessel obstruction % with angiography (p-value <0.0001). CONCLUSION: ECG is one of the predictive tools which can be used to detect the outcome of the disease, Patients with a low QRS amplitude score are more prone to complications and longer hospital stays. Therefore, it is essential to correlate the reciprocal changes in the ECG and angiography for a better clinical assessment and to provide an adequate therapeutic outcome. A lower QRS amplitude score has also affected the ejection fraction (EF%) and can be correlated with the % vessel obstruction. Hence, ECG can be used as an early diagnostic tool for predicting the severity of STEMI and non-STEMI disease in patients.
| Item Type: | Thesis (Masters) |
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| Additional Information: | Reg.No.200120102003 |
| Uncontrolled Keywords: | QRS Amplitude, ECG, ST Elevated Myocardial Infarction, Vessel Involvement, Coronary Angiogram. |
| Subjects: | MEDICAL > General Medicine > MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 04 May 2021 09:01 |
| Last Modified: | 22 Mar 2024 15:51 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/15773 |
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