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Research in the late 2000s has linked this finding to ventricular fibrillation, particularly in those who have fainted or have a family history of sudden cardiac death. [5] [6] [7] Although there is a significant relationship between ventricular fibrillation and some early repolarization's patterns, the overall lifetime occurrence of idiopathic ventricular fibrillation is exceptionally rare. [8]
The clinician must therefore be well versed in recognizing the so-called ECG mimics of acute myocardial infarction, which include left ventricular hypertrophy, left bundle branch block, paced rhythm, early repolarization, pericarditis, hyperkalemia, and ventricular aneurysm. [7] [8] [9] Localisation of the occlusion in the ECG showing STEMI changes
The ST segment starts from the J point (termination of QRS complex and the beginning of ST segment) and ends with the T wave.The ST segment is the plateau phase, in which the majority of the myocardial cells had gone through depolarization but not repolarization.
The T wave represents the repolarization of the ventricles. It is generally upright in all leads except aVR and lead V1. Inverted T waves can be a sign of myocardial ischemia, left ventricular hypertrophy, high intracranial pressure, or metabolic abnormalities. Peaked T waves can be a sign of hyperkalemia or very early myocardial infarction. 160 ms
Cellular mechanisms of early afterdepolarizations (EADs) and delayed afterdepolarizations (DADs). Delayed afterdepolarizations (DADs) begin during phase 4, after repolarization is completed but before another action potential would normally occur via the normal conduction systems of the heart.
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Moreover, in the post-resuscitation patient, a 12-lead EKG can help identify some causes of cardiac arrest, such as STEMI which may require specific treatments. Point-of-care ultrasound (POCUS) is a tool that can be used to examine the movement of the heart and its force of contraction at the patient's bedside. [ 66 ]