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ECG Changes After Alteplase Therapy in Patients with Acute Myocardial Infarction

Author: Zaid A.MustafaAl-Najjar* ,Zahraa H.Ismaeel**, Amar Zedan Omran
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2016 Volume: 15 Issue: 2 Pages: 158-162
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية


ABSTRACT:BACKGROUND: Acute myocardial infarction is a major cause of death throughout the world. Many important advances have become available to Coronary Care Units enabling them to reduce mortality and improve the prognosis, Reperfusion therapy is one of these important advances. OBJECTIVE: This study sought to identify the Electro-cardiographic (ECG ) changes which occur after receiving Alteplase therapy and its relation to response to thrombolytic therapy. METHODS : Seventy-three patients with ST- elevation Acute Myocardial Infarction (AM I) who received Alteplase within 12 hours from the start of symptoms in coronary care unit were included in this study. Electro-cardiographic (ECG) was done to all patients at time of arrival to the coronary care unit(CCU), Alteplase therapy was given to all patients plus heparin intravenously, followed by electro-cardiographic (ECG ) every 30 minutes for 2 hours.RESULTS:Fifty-seven and half percent of our patients showed 50% reduction in the ST segment elevation in the worst lead after 2 hours from starting Alteplase therapy and regarded as responders. Other ECG changes like rapid appearance of Q wave, T inversion, accelerated idioventricular rhythm (AIVR) are found to be specific for reperfusion with a high predictive value when the gold standard criteria was reduction 50 % in the ST segment elevation Resolution of reciprocal changes is sensitive and specific with high predictive value. CONCLUSION :Some ECG changes after thrombolytic therapy can predict the response in addition to the already known changes. .

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