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Exercise testing score for myocardial ischemia gradation.

Uchida AH, Moffa P, Riera AR - Indian Pacing Electrophysiol J (2007)

View Article: PubMed Central - PubMed

Affiliation: Heart Institute - University of Sao Paulo Medical School, Brazil. augusto.uchida@incor.usp.br

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Scores aimed at contributing to the optimization of exercise testing (ET) have been developed and the experience with their application in coronary artery disease (CAD) has proven to be favorable... Although there is debate on the use of scores in clinical practice, those that stand for it argue that they may decrease the rate of undiagnosed CAD, besides reducing the number of patients without disease that undergo highly expensive tests... Scores to assess CAD may be classified didactically, as pre-test, post-test, simplified, multivariate, diagnostic or prognostic... A diagnostic score may be prognostic when severe CAD estimation is made (i,e. multi-vessel disease pattern, left truncus lesion)... ST segment shift from 1.6 to 2.0 mm... ST segment elevation or depression superior to 1.5 mm and inferior or equal to 2.0 mm... ST segment shift superior to 2.0 mm... To be able to document myocardial ischemia, there is a series of factors that should be considered: presence of critical coronary obstruction, number of coronary arteries with critical lesions, presence of collateral circulation, location of coronary obstruction, extension of ischemia, insufficient increase of myocardial demand of oxygen, anemia, concomitant valve diseases, superimposed coronary spasm, hydroelectrolytic disorders, number of electrocardiographic leads, position of electrodes, limitations in acquisition and processing of cardiac electric signal, baseline electrocardiogram alterations, quality of electrocardiographic recording, QRS complex width, therapeutic influence, etc... The result of the ST does not confirm the presence or absence of CAD, and it should be correlated with other pertinent data for a more coherent probabilistic analysis... Training on the application of scales in clinical assays, may favor a better systematization of data... In practice, this ischemia score may prevent badly structured and disorganized clinical cases from resulting in ambiguities and misunderstandings, positioning the patient in a better defined prognostic and/or diagnostic category.

No MeSH data available.


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Patterns related to the time and duration of ST segment deviations for the analysis of ischemia score.
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Figure 2: Patterns related to the time and duration of ST segment deviations for the analysis of ischemia score.

Mentions: To score this component, 5 patterns are considered that are exemplified in Figure 2:


Exercise testing score for myocardial ischemia gradation.

Uchida AH, Moffa P, Riera AR - Indian Pacing Electrophysiol J (2007)

Patterns related to the time and duration of ST segment deviations for the analysis of ischemia score.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1764910&req=5

Figure 2: Patterns related to the time and duration of ST segment deviations for the analysis of ischemia score.
Mentions: To score this component, 5 patterns are considered that are exemplified in Figure 2:

View Article: PubMed Central - PubMed

Affiliation: Heart Institute - University of Sao Paulo Medical School, Brazil. augusto.uchida@incor.usp.br

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Scores aimed at contributing to the optimization of exercise testing (ET) have been developed and the experience with their application in coronary artery disease (CAD) has proven to be favorable... Although there is debate on the use of scores in clinical practice, those that stand for it argue that they may decrease the rate of undiagnosed CAD, besides reducing the number of patients without disease that undergo highly expensive tests... Scores to assess CAD may be classified didactically, as pre-test, post-test, simplified, multivariate, diagnostic or prognostic... A diagnostic score may be prognostic when severe CAD estimation is made (i,e. multi-vessel disease pattern, left truncus lesion)... ST segment shift from 1.6 to 2.0 mm... ST segment elevation or depression superior to 1.5 mm and inferior or equal to 2.0 mm... ST segment shift superior to 2.0 mm... To be able to document myocardial ischemia, there is a series of factors that should be considered: presence of critical coronary obstruction, number of coronary arteries with critical lesions, presence of collateral circulation, location of coronary obstruction, extension of ischemia, insufficient increase of myocardial demand of oxygen, anemia, concomitant valve diseases, superimposed coronary spasm, hydroelectrolytic disorders, number of electrocardiographic leads, position of electrodes, limitations in acquisition and processing of cardiac electric signal, baseline electrocardiogram alterations, quality of electrocardiographic recording, QRS complex width, therapeutic influence, etc... The result of the ST does not confirm the presence or absence of CAD, and it should be correlated with other pertinent data for a more coherent probabilistic analysis... Training on the application of scales in clinical assays, may favor a better systematization of data... In practice, this ischemia score may prevent badly structured and disorganized clinical cases from resulting in ambiguities and misunderstandings, positioning the patient in a better defined prognostic and/or diagnostic category.

No MeSH data available.


Related in: MedlinePlus