Academic literature on the topic 'Segment ST-T'
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Journal articles on the topic "Segment ST-T"
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Widodo, Gipta Galih, Elly Nurachmah, and Budiharto Budiharto. "Efek Cold Pressor Test Terhadap Pasokan dan Kebutuhan Oksigen Miokard Pada Perokok Aktif di Kecamatan Ungaran Kabupaten Semarang." Jurnal Keperawatan Indonesia 12, no. 1 (March 24, 2008): 14–20. http://dx.doi.org/10.7454/jki.v12i1.194.
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AbstrakPenelitian kuasi eksperimen ini bertujuan menguji pengaruh cold pressor test (CPT) terhadap pasokan dan kebutuhan oksigen miokard pada perokok aktif dengan pengukuran tekanan darah dan segmen ST di Kecamatan Ungaran Kabupaten Semarang. Jumlah sampel dalam penelitian ini sebanyak 76 perokok aktif di Kecamatan Ungaran Kabupaten Semarang dan ditentukan dengan cluster sampling. Pengaruh CPT terhadap tekanan darah dan segmen ST pada perokok aktif diuji dengan dependent sample t test. Hasil penelitian menunjukkan rerata tekanan darah setelah intervensi CPT mengalami penurunan. Hasil analisis dengan uji t test menunjukkan bahwa CPT menurunkan tekanan darah setelah intervensi CPT (p=0,000). Rata-rata segmen ST sebelum dan setelah intervensi CPT tidak jauh berbeda. Hasil uji t test menunjukkan bahwa CPT tidak berpengaruh dalam menurunkan segmen ST pada perokok aktif (p = 0,895). Penelitian ini menyimpulkan bahwa CPT berpengaruh terhadap perubahan tekanan darah pada perokok aktif tetapi tidak berpengaruh terhadap perubahan segmen ST. Selama CPT terjadi peningkatan tekanan darah dan berangsur menurun setelah dilakukan CPT. Segmen ST tidak mengalami perubahan. CPT dapat digunakan oleh perawat untuk memprediksi kejadian peningkatan tekanan darah. Untuk penelitian selanjutnya sebaiknya digunakan alat ukur yang lebih sensitif dan menggunakan determinan pasokan dan kebutuhan oksigen miokard yang lain seperti preload dan denyut jantung. AbstractThis quasy-experimental research was aimed to examine the effect of cold pressor test (CPT) to the myocardial oxygen demand and supply among active smokers in the Ungaran district, Semarang by measuring blood pressure and ST segment. There were 76 active smoker males involved as the cluster sampling in the research. To examine the CPT effect on the blood pressure and ST segment among the active smokers, dependent sample t test was conducted. The result of the research showed that average blood pressure is decreased after CPT. Furthermore, CPT showed its effects on decreasing blood pressure after the intervention (p = 0,000). The averages of ST segment before and after intervention of CPT were slightly different. Thus, CPT indicated no significant impact in decreasing ST segment among active smokers (p = 0,895). The research concluded that CPT caused blood pressure changes among active smokers but do not have effect in ST segment changes. On the other hand, it was observed that the initial blood pressure were increase during CPT but then gradually decreased immediately after the end of CPT. In addition, ST segment remained unchanged. Therefore, the CPT is still beneficial for predicting high blood pressure in patient compared to other cardiac stress test. Nevertheless, it is recommended to use more sensitive device and to consider other determinants of the myocardial oxygen demand and supply such as preload and heart beat for further research.
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Xiao, Li, Tao Bai, Junchao Zeng, Rui Yang, and Ling Yang. "Nonalcoholic fatty liver disease, a potential risk factor of non-specific ST-T segment changes: data from a cross-sectional study." PeerJ 8 (May 13, 2020): e9090. http://dx.doi.org/10.7717/peerj.9090.
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Background Non-specific ST-T segment changes are prevalent and are proven risk factors for early onset of cardiovascular diseases. They can increase all-cause mortality by 100∼200% and are candidate for early signs of cardiovascular changes. Nonalcoholic fatty liver disease (NAFLD) is prevalent worldwide and is one facet of a multisystem disease that confers substantial increases morbidity and mortality of nonalcoholic fatty liver-related cardiovascular diseases. It is unclear whether NAFLD is associated with non-specific ST-T changes warning early signs of cardiovascular changes. Therefore, we investigated this association. Methods A cross-sectional study was designed that included a sample consisting of 32,922 participants who underwent health examinations. Participants with missing information, excessive alcohol intake, viral hepatitis, chronic liver disease or established cardiovascular diseases were excluded. Electrocardiograms were used for analysis of non-specific ST-T segment changes. NAFLD was diagnosed by ultrasonographic detection of hepatic steatosis without other liver diseases. A multivariable logistic regression model was served to calculate the OR and 95% CI for non-specific ST-T segment changes. Results The prevalence of non-specific ST-T segment changes was 6.5% in participants with NAFLD, however, the prevalence of NAFLD was 42.9% in participants with non-specific ST-T segment changes. NAFLD was independently associated with non-specific ST-T segment changes (OR: 1.925, 95% CI: 1.727-2.143, P < 0.001). After adjusting for age, sex, heart rate, hypertension, body mass index, fasting glucose, total cholesterol, triglycerides, HDL-C, NAFLD remained an independent risk factor of non-specific ST-T segment changes (OR: 1.289, 95% CI: 1.122-1.480). Conclusion Non-specific ST-T segment changes were independently associated with the presence of NAFLD after adjusting for potential confounders.
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Rapp, H. J., S. Rabethge, T. Luiz, and P. Haux. "Perioperative ST-segment depression and troponin T release." Acta Anaesthesiologica Scandinavica 43, no. 2 (February 1999): 124–29. http://dx.doi.org/10.1034/j.1399-6576.1999.430202.x.
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Ivanov, Igor, Anastazija Stojsic-Milosavljevic, Vladimir Ivanovic, Milos Trajkovic, Aleksandra Vulin, and Milenko Cankovic. "ST elevation myocardial infarction equivalent - De Winter T-wave electrocardiography pattern." Medical review 71, no. 7-8 (2018): 265–69. http://dx.doi.org/10.2298/mpns1808265i.
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Introduction. Rapid diagnosis of acute myocardial infarction is essential for proper treatment and reduction of patient mortality. Electrocardiography plays an important role in its diagnosis. Acute myocardial infarction with ST segment elevation requires urgent reperfusion therapy, that is, primary percutaneous coronary revascularization. A small number of patients with acute myocardial infarction have ST segment depression in one or more leads, whereas ST segment elevation in augmented vector right the electrocardiogram is characteristic for a myocardial infarction without ST elevation, but the clinical course and the severity of disease correspond to the anterior myocardial infarction with ST segment elevation. De Winter T-wave electrocardiography. One of these forms is known as de Winter T-wave pattern, characterized by ST segment depression at the J-point (> 1 mm) in the precordial leads, the absence of ST segment elevation in the precordial leads, high peaked and symmetrical T-waves in the precordial leads and, in most cases, mild ST segment elevation (0.5 mm to 1 mm) in the augmented vector right. These patients have occlusion of the left main coronary artery, occlusion of the proximal segment of the anterior descending artery, or a severe multivessel coronary disease. Patients with this electrocardiographic pattern, which is equivalent to acute myocardial infarction with ST segment elevation, require consideration of emergency reperfusion therapy due to high mortality, compared to other patients with acute myocardial infarction without ST elevation. Primary percutaneous intervention is recommended, or if there is no catheterization laboratory nearby, fibrinolytic therapy may be considered. Because of the lack of clear recommendations, treatment decisions are made individually, from case to case. Conclusion. We need large pro?spective studies with this specific electrocardiographic pattern to provide quick recognition and proper treatment of the anterior myocardial infarction with ST elevation.
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Meijs, Loek P. B., Loriano Galeotti, Esther P. Pueyo, Daniel Romero, Robert B. Jennings, Michael Ringborn, Stafford G. Warren, Galen S. Wagner, and David G. Strauss. "An electrocardiographic sign of ischemic preconditioning." American Journal of Physiology-Heart and Circulatory Physiology 307, no. 1 (July 1, 2014): H80—H87. http://dx.doi.org/10.1152/ajpheart.00419.2013.
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Ischemic preconditioning is a form of intrinsic cardioprotection where an episode of sublethal ischemia protects against subsequent episodes of ischemia. Identifying a clinical biomarker of preconditioning could have important clinical implications, and prior work has focused on the electrocardiographic ST segment. However, the electrophysiology biomarker of preconditioning is increased action potential duration (APD) shortening with subsequent ischemic episodes, and APD shortening should primarily alter the T wave, not the ST segment. We translated findings from simulations to canine to patient models of preconditioning to test the hypothesis that the combination of increased [delta (Δ)] T wave amplitude with decreased ST segment elevation characterizes preconditioning. In simulations, decreased APD caused increased T wave amplitude with minimal ST segment elevation. In contrast, decreased action potential amplitude increased ST segment elevation significantly. In a canine model of preconditioning (9 mongrel dogs undergoing 4 ischemia-reperfusion episodes), ST segment amplitude increased more than T wave amplitude during the first ischemic episode [ΔT/ΔST slope = 0.81, 95% confidence interval (CI) 0.46–1.15]; however, during subsequent ischemic episodes the T wave increased significantly more than the ST segment (ΔT/ΔST slope = 2.43, CI 2.07–2.80) ( P < 0.001 for interaction of occlusions 2 vs. 1). A similar result was observed in patients (9 patients undergoing 2 consecutive prolonged occlusions during elective percutaneous coronary intervention), with an increase in slope of ΔT/ΔST of 0.13 (CI −0.15 to 0.42) in the first occlusion to 1.02 (CI 0.31–1.73) in the second occlusion ( P = 0.02). This integrated analysis of the T wave and ST segment goes beyond the standard approach to only analyze ST elevation, and detects cellular electrophysiology changes of preconditioning.
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SONG, JINZHONG, HONG YAN, ZHIJUN XIAO, XIANGLIN YANG, and XIAODONG ZHANG. "A ROBUST AND EFFICIENT ALGORITHM FOR ST–T COMPLEX DETECTION IN ELECTROCARDIOGRAMS." Journal of Mechanics in Medicine and Biology 11, no. 05 (December 2011): 1103–11. http://dx.doi.org/10.1142/s0219519411004198.
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Changes of ST–T complex are the main indicators in myocardial ischemia detection based on electrocardiogram (ECG) signals. However, ST–T complex is highly sensitive to interferences (baseline wandering, postural changes, electrode interference, etc.), especially T-wave has a large morphological variability. Therefore, the feature points of ECG ST–T complex are very difficult to detect accurately. Currently, the commonly used detection methods for ST-segment include R + x and J + x, but they often misjudges the T-wave rising limb as ST-segment. Therefore, a new accurate hybrid approach for ST–T detection was proposed in this paper. First, T-wave onsets and offsets were detected using regional method and T-wave peaks were located using function comparing method. Then, a squeeze approach for ST-segment detection was proposed based on R-wave peak and T-wave onset. Long-term ST database (LTST) verification demonstrated that the accuracy of ST–T detection reached above 91%. In addition, it had a good timeliness and robustness and was easy to implement.
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Dejanovic, Jadranka, Anastazija Stojsic-Milosavljevic, Milos Trajkovic, Tanja Popov, and Aleksandra Ilic. "Atypical electrocardiographic presentations of myocardial infarction with ST elevation - ST elevation myocardial infarction equivalents." Medical review 71, no. 7-8 (2018): 241–46. http://dx.doi.org/10.2298/mpns1808241d.
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Introduction. Some patients with clinical symptoms and signs of acute myocardial and coronary artery occlusion have atypical electrocardiographic presentations - ST elevation myocardial infarction equivalents. Rapid recognition of these patterns is imperative, because the condition requires prompt reperfusion therapy following actual guidelines. De Winter pattern. Diagnostic criteria are: tall, prominent, symmetrical T-waves in the precordial leads, upsloping ST segment depression > 1 mm at the J-point in the precordial leads, absence of ST elevation in the precordial leads, ST segment elevation (0.5 mm - 1 mm) in aVR. ST Elevation in aVR. Electrocardiographic criteria include ST segment elevation in aVR ? 1 mm, ST segment elevation in aVR ? V1, and diffuse ST segment depression in lateral leads. Wellens syndrome. Wellens syndrome describes deeply inverted or bi?phasic T-waves in leads V2 - V3, highly specific for significant stenosis of the left anterior descending artery. Posterior infarction. Posterior infarction is confirmed with ST segment depression ? 0,5 mm in leads V1 - 3 and ST segment elevation ? 0.5 mm in posterior leads (V7 - V9). Conclusion. There are many electrocardiographic patterns that physicians should promptly recognize as clinical myocardial infarction with ST segment elevation equivalents in order to perform urgent reperfusion therapy for better prognosis and survival in these patients.
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Beckenbauer, Dominik, Valeria Martínez Pereyra, and Peter Ong. "STEMI-Äquivalente im EKG – eine fallbasierte Darstellung." DMW - Deutsche Medizinische Wochenschrift 145, no. 05 (March 2020): 318–26. http://dx.doi.org/10.1055/a-0999-0101.
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AbstractThe 12-lead resting ECG remains an indispensable diagnostic tool in patients with acute chest pain. This is particularly important as the identification of ST-segment elevations leads to the diagnosis of ST-segment elevation myocardial infarction (STEMI) and subsequent, immediate coronary reperfusion (usually via primary PCI). However, correct interpretation of the 12-lead ECG in patients with acute chest pain remains challenging. Apart from “classical” ST-segment elevations there are several “equivalents” in the ECG pointing towards an acute coronary occlusion. Among these, hyperacute T-waves, subtle ST-segment elevations, ST-segment elevation in leads aVR/V1 with concomitant ST-segment depression in ≥ 8 other leads and high R-peak with positive T-waves combined with horizontal ST-segment depression in leads V1/V2 can be found. This article provides a case-based presentation of STEMI equivalents on the ECG in order to improve correct ECG interpretation and prognosis of such patients.
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Kumar, Amit, and Mandeep Singh. "Statistical analysis of ST segments in ECG signals for detection of ischaemic episodes." Transactions of the Institute of Measurement and Control 40, no. 3 (October 7, 2016): 819–30. http://dx.doi.org/10.1177/0142331216667811.
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This paper highlights a new method for the detection of ischaemic episodes using statistical features derived from ST segment deviations in electrocardiogram (ECG) signal. Firstly, ECG records are pre-processed for the removal of artifacts followed by the delineation process. Then region of interest (ROI) is defined for ST segment and isoelectric reference to compute the ST segment deviation. The mean thresholds for ST segment deviations are used to differentiate the ischaemic beats from normal beats in two stages. The window characterization algorithm is developed for filtration of spurious beats in ischaemic episodes. The ischaemic episode detection is made through the coefficient of variation (COV), kurtosis and form factor. A bell-shaped normal distribution graph is generated for normal and ischaemic ST segments. The results show average sensitivity (Se) 97.71% and positive predictivity (+P) 96.89% for 90 records of the annotated European ST-T database (EDB) after validation. These results are significantly better than those of the available methods reported in the literature. The simplicity and automatic discarding of irrelevant beats makes this method feasible for use in clinical systems.
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Chronister, Connie. "Improving Nurses’ Knowledge of Continuous ST-Segment Monitoring." AACN Advanced Critical Care 25, no. 2 (April 1, 2014): 104–13. http://dx.doi.org/10.4037/nci.0000000000000029.
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Background: Continuous ST-segment monitoring can result in detection of myocardial ischemia, but in clinical practice, continuous ST-segment monitoring is conducted incorrectly and underused by many registered nurses (RNs). Many RNs are unable to correctly institute ST-segment monitoring guidelines because of a lack of education. Purpose: To evaluate whether an educational intervention, provided to 32 RNs, increases knowledge and correct clinical decision making (CDM) for the use of continuous ST-segment monitoring. Methods: At a single institution, an ST-segment monitoring class was provided to RNs in 2 cardiovascular units. Knowledge and correct CDM instruments were used for a baseline pretest and subsequent posttest after ST-segment monitoring education. Results: Statistical significance between pretest and posttest scores for knowledge and correct CDM practice was noted with dependent t tests (P = .0001). Conclusions: Many RNs responsible for electrocardiographic monitoring are not aware of evidence-based ST-segment monitoring practice guidelines and cannot properly place precordial leads needed for ST-segment monitoring. Knowledge and correct CDM with ST-segment monitoring can be improved with focused education.
Dissertations / Theses on the topic "Segment ST-T"
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Tannenberg, Milan. "Analýza ST-T segmentů v signálech EKG se zaměřením na alternace vlny T." Doctoral thesis, Vysoké učení technické v Brně. Fakulta elektrotechniky a komunikačních technologií, 2009. http://www.nusl.cz/ntk/nusl-233444.
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The Cardiovascular diseases may evocated the high percentual risk of sudden cardiac death in whole world. In several western countries is the number of death higher then number of cancer death. In this time is used a lot of methods for prediction of sudden cardiac death with focus on ECG T-wave alternance. The aim of the theses was to do stronger relation and cooperation with Internal Cardiac Clinic of Faculty Hospital Brno Bohunice on the risk analysis of sudden cardiac death. Secondly, we met the methods used for detection and quantification of simulated TWA. Last but not least was necessary to find TWA detection methods improvement and process the data on real signals obtained from Faculty Hospital Brno Bohunice. First part of the Thesis is focused on summary of pathologic artifacts in ECG signal, which are important for sudden cardiac risk stratification. There are described further known detection and quantification methods for TWA analysis. An interesting part for clinical practice is analysis of TWA trend in time and looking for the best method, which is able to catch and track the short TWA trend changes. Second part describes the new methods improvements, which were tested with interesting outputs. Further, there was developed method for TWA presence statement probability evaluation.
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Alquézar, Arbé Aitor. "Troponina T d'elevada sensibilitat per a l'exclusió precoç de l'infart agut de miocardi sense elevació del segment st." Doctoral thesis, Universitat Autònoma de Barcelona, 2014. http://hdl.handle.net/10803/284855.
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Introducció: el dolor toràcic suggestiu d´isquèmia miocàrdica és un motiu de consulta molt freqüent en el SU, si bé, s’acaba descartant origen coronari en la majoria d´aquests pacients. Cal optimitzar el maneig diagnòstic d´aquesta entitat. Actualment, la determinació seriada de Tnc ( valor Δ ) és un component imprescindible en el diagnòstic de l´IAMSEST. Recentment s´han introduït noves immunoanàlisis denominades Tnc-es que han canviat el paradigma del diagnòstic d´IAMSEST. Aquestes immunoanàlisis faciliten un diagnòstic precoç de l´IAMSEST, permeten el diagnòstic d´IAMSEST de petita mida, ja que són molt específiques per diagnosticar lesió miocàrdica, però no són específiques per identificar la causa de la lesió miocàrdica; és a dir, la determinació de Tnc-es pot ser elevada en situacions diferents d´una oclusió trombòtica coronària.
Es recomana la implementació d´algoritmes basats en la determinació de Tnc-es per al diagnòstic precoç de l´IAMSEST, si bé hi ha qüestions no resoltes sobre la seva utilització: Ús d´algoritmes de diagnòstic ràpid d´IAMSEST. Moment temporal òptim per fer la determinació seriada. Valor Δ òptim (absolut o percentual) per fer el diagnòstic d´IAMSEST .
Objectius: Validar un algoritme per a l´exclusió precoç de l´IAMSEST. Valorar el moment temporal òptim per fer la determinació seriada i determinar el tipus de valor òptim per al diagnòstic d´IAMSEST
Mètodes: Cohort prospectiva reclutada en el servei d´urgències d´un hospital universitari en la què es realitzen determinacions seriades de TnTc-es: a la inclusió, a 1 hora, a 2 hores i >4 hores.
Resultats: La determinació seriada a 0->4h té millor rendiment diagnòstic que les determinacions a 0-1h, 0-2h (p<0.05). En l´interval 0->4h es pot fer servir valor Δ absolut o percentual (p = 0.36).
L´ús d´un algoritme a 0->4h amb valor Δ percentual o absolut permet excloure el diagnòstic d´IAMSEST (Se 100%).
L´ús d´un algoritme a menys de 4h genera un grup de casos en els quals és obligat utilitzar criteris addicionals per confirmar o excloure el diagnòstic d´IAMSEST.
Conclusions: L´ús d´un algoritme a 0->4h amb valor Δ percentual o absolut permet excloure el diagnòstic d´IAMSEST. En casos seleccionats, es pot excloure o confirmar el diagnòstic amb una determinació única de TnTc-es o plantejar l´ús d´algoritme 1 h amb valor Δ absolut.
L´ús d´aquests algoritmes no es pot utilitzar per donar d´alta de forma precoç als pacients sense IAMSEST; alguns d´aquests casos són AI, i requereixen proves addicionals per al seu maneig.Background: Chest pain suggestive of myocardial ischemia is a very common chief complaint in the Emergency Department. However, myocardial ischemia is ruled out in the majority of these cases. It is necessary to optimize the diagnostic management of chest pain. A rise and/or fall (Δ value) in levels in cTn is obligatory criteria for the diagnosis of NSTEMI. The development and introduction of new immunoassay (hs-cTnT) have changed the diagnostic approach of NSTEMI. This immunoassay not only facilitates early diagnosis of NSTEMI, but it also allows the diagnosis of small size NSTEMI. This immunoassay is highly specific tool for diagnosing myocardial injury; however, they do not identify the cause of myocardial injury. As a consequence, hs-cTnT can be elevated in many situations different of a thrombotic occlusion of a coronary artery. It is recommended the implementation of algorithms based on hs-cTnT for the early diagnosis of NSTEMI, although there are unresolved questions about its use: Implementation of rapid diagnostic algorithms for NSTEMI. Best moment for sample collection. Optimal Δ value (absolute or relative) for NSTEMI diagnosis. Objectives: To validate an algorithm for early exclusion of acute myocardial infarction diagnosis. To evaluate the best moment to sample collection and to determine the optimal kinetic change for the diagnosis of NSTEMI. Methods: Prospective cohort enrolled in an emergency department of a university hospital. Sample collection were obtained at study inclusion, and at 1 hour, 2 hours and >4 hours Results: Determination 0->4hours has a better diagnostic performance than 0-1h or 0-2h (p>0.05). In this interval, there is no difference between relative and absolute Δ values (p=0.36). The use of an algorithm 0->4h with absolute or relative Δ values allows to exclude NSTEMI (Sensitivity 100%). The use of an algorithm 0-1h generates a group of patients who require additional criteria to confirm or exclude NSTEMI. Conclusions: Using an algorithm with 0->4h with absolute or relative Δ value allows to exclude NSTEMI. In selected cases, it is possible to confirm or exclude the diagnosis with a single sample. In some situations, it can be useful an algorithm with 0-1h with absolute Δ value. These algorithms cannot be used to discharge patients without NSTEMI. Some of these cases are unstable anginas and require additional tests for diagnosis.
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Hadjem, Medina. "Contribution à l'analyse et à la détection automatique d'anomalies ECG dans le cas de l'ischémie myocardique." Thesis, Sorbonne Paris Cité, 2016. http://www.theses.fr/2016USPCB011.
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Les récentes avancées dans le domaine de la miniaturisation des capteurs biomédicaux à ultra-faible consommation énergétique, permettent aujourd’hui la conception de systèmes de télésurveillance médicale, à la fois plus intelligents et moins invasifs. Ces capteurs sont capables de collecter des signaux vitaux tels que le rythme cardiaq ue, la température, la saturation en oxygène, la pression artérielle, l'ECG, l'EMG, etc., et de les transmettre sans fil à un smartphone ou un autre dispositif distant. Ces avancées sus-citées ont conduit une large communauté scientifique à s'intéresser à la conception de nouveaux systèmes d'analyse de données biomédicales, en particulier de l’électrocardiogramme (ECG). S’inscrivant dans cette thématique de recherche, la présente thèse s’intéresse principalement à l’analyse et à la détection automatique des maladies cardiaques coronariennes, en particulier l’ischémie myocardique et l’infarctus du myocarde (IDM). A cette fin, et compte tenu de la nature non stationnaire et fortement bruitée du signal ECG, le premier défi a été d'extraire les paramètres pertinents de l’ECG, sans altérer leurs caractéristiques essentielles. Cette problématique a déjà fait l’objet de plusieurs travaux et ne représente pas l’objectif principal de cette thèse. Néanmoins, étant un prérequis incontournable, elle a nécessité une étude et une compréhension de l'état de l'art afin de sélectionner la méthode la plus appropriée. En s'appuyant sur les paramètres ECG extraits, en particulier les paramètres relatifs au segment ST et à l'onde T, nous avons contribué dans cette thèse par deux approches d'analyse ECG : (1) Une première analyse réalisée au niveau de la série temporelle des paramètres ECG, son objectif est de détecter les élévations anormales du segment ST et de l'onde T, connues pour être un signe précoce d'une ischémie myocardique ou d’un IDM. (2) Une deuxième analyse réalisée au niveau des battements de l’ECG, dont l’objectif est la classification des anomalies du segment ST et de l’onde T en différentes catégories. Cette dernière approche est la plus utilisée dans la littérature, cependant, il est difficile d’interpréter les résultats des travaux existants en raison de l'absence d’une méthodologie standard de classification. Nous avons donc réalisé notre propre étude comparative des principales méthodes de classification utilisées dans la littérature, en prenant en compte diverses classes d'anomalies ST et T, plusieurs paramètres d'évaluation des performances ainsi que plusieurs dérivations du signal ECG. Afin d'aboutir à des résultats plus significatifs, nous avons également réalisé la même étude en prenant en compte la présence d'autres anomalies cardiaques fréquentes dans l’ECG (arythmies). Enfin, en nous basant sur les résultats de cette étude comparative, nous avons proposé une nouvelle approche de classification des anomalies ST-T en utilisant une combinaison de la technique du Boosting et du sous-échantillonnage aléatoire, notre objectif étant de trouver le meilleur compromis entre vrais-positifs et faux-positifsRecent advances in sensing and miniaturization of ultra-low power devices allow for more intelligent and wearable health monitoring sensor-based systems. The sensors are capable of collecting vital signs, such as heart rate, temperature, oxygen saturation, blood pressure, ECG, EMG, etc., and communicate wirelessly the collected data to a remote device and/or smartphone. Nowadays, these aforementioned advances have led a large research community to have interest in the design and development of new biomedical data analysis systems, particularly electrocardiogram (ECG) analysis systems. Aimed at contributing to this broad research area, we have mainly focused in this thesis on the automatic analysis and detection of coronary heart diseases, such as Ischemia and Myocardial Infarction (MI), that are well known to be the leading death causes worldwide. Toward this end, and because the ECG signals are deemed to be very noisy and not stationary, our challenge was first to extract the relevant parameters without losing their main features. This particular issue has been widely addressed in the literature and does not represent the main purpose of this thesis. However, as it is a prerequisite, it required us to understand the state of the art proposed methods and select the most suitable one for our work. Based on the ECG parameters extracted, particularly the ST segment and the T wave parameters, we have contributed with two different approaches to analyze the ECG records: (1) the first analysis is performed in the time series level, in order to detect abnormal elevations of the ST segment and the T wave, known to be an accurate predictor of ischemia or MI; (2) the second analysis is performed at the ECG beat level to automatically classify the ST segment and T wave anomalies within different categories. This latter approach is the most commonly used in the literature. However, lacking a performance comparison standard in the state of the art existing works, we have carried out our own comparison of the actual classification methods by taking into account diverse ST and T anomaly classes, several performance evaluation parameters, as well as several ECG signal leads. To obtain more realistic performances, we have also performed the same study in the presence of other frequent cardiac anomalies, such as arrhythmia. Based on this substantial comparative study, we have proposed a new classification approach of seven ST-T anomaly classes, by using a hybrid of the boosting and the random under sampling methods, our goal was ultimately to reach the best tradeoff between true-positives and false-positives
Books on the topic "Segment ST-T"
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Erlinge, David, and Göran Olivecrona. Diagnosis and management of non-STEMI coronary syndromes. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0146.
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Acute coronary syndromes are classified as ST segment elevation myocardial infarction (STEMI), non-STEMI (NSTEMI) or unstable angina. Most patients with NSTEMI present with a history of chest pain that has subsided spontaneously before or soon after arrival at the emergency room, but with positive cardiac markers (usually troponin T or I) indicative of myocardial infarction. NSTEMI has a risk of recurrent myocardial infarction of 15–20% and a 15% chance of 1-year mortality. Patients with non-STE-acute coronary syndromes are at similar risk as a STEMI patient at 1 year. The strongest objective signs of NSTEMI are a positive troponin and ST segment depression. NSTEMI should be acutely treated with aspirin, an adenosine diphosphate-receptor antagonist, and an anticoagulant (fondaparinux or low molecular weight heparins). NSTEMI should be investigated with coronary angiography within 72 hours. Curative treatment is percutaneous coronary intervention or coronary artery bypass grafting.
Book chapters on the topic "Segment ST-T"
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Brady, William J. "Chest Pain with Electrocardiographic ST-Segment/T-Wave Abnormalities." In Visual Diagnosis in Emergency and Critical Care Medicine, 26–27. Oxford, UK: Blackwell Publishing Ltd, 2008. http://dx.doi.org/10.1002/9780470755921.ch41.
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Brady, William J. "Chest Pain with Electrocardiographic ST Segment and T Wave Abnormalities." In Visual Diagnosis in Emergency and Critical Care Medicine, 58. Oxford, UK: Wiley-Blackwell, 2011. http://dx.doi.org/10.1002/9781444397994.ch86.
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"Chest Pain with Electrocardiographic ST-Segment/T-Wave Abnormalities." In Visual Diagnosis in Emergency and Critical Care Medicine, 103–4. Oxford, UK: Blackwell Publishing Ltd, 2008. http://dx.doi.org/10.1002/9780470755921.ch141.
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"Chest Pain with Electrocardiographic ST Segment and T Wave Abnormalities." In Visual Diagnosis in Emergency and Critical Care Medicine, 159–60. Oxford, UK: Wiley-Blackwell, 2011. http://dx.doi.org/10.1002/9781444397994.ch196.
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"ST Segment Depression (4-Codes) and Negative T-Waves (5-Codes)." In The Minnesota Code Manual of Electrocardiographic Findings, 60–97. London: Springer London, 2010. http://dx.doi.org/10.1007/978-1-84882-778-3_7.
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Migliore, Federico, Sebastiano Gili, and Domenico Corrado. "ECG features and arrhythmias in takotsubo syndrome." In ESC CardioMed, 1298–301. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0320.
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Takotsubo syndrome (TTS) is typically characterized by dynamic electrocardiographic (ECG) repolarization changes, which consist of mild ST-segment elevation on presentation (acute phase) followed by T-wave inversion with QT interval prolongation within 24–48 h after presentation (subacute phase). It is noteworthy that subacute ECG repolarization abnormalities of TTS resemble those of the so-called Wellens’ ECG pattern, which is characterized by transient T-wave inversion in the anterior precordial leads as a result of either myocardial ischaemia or other non-ischaemic conditions, all characterized by a reversible left ventricular dysfunction (‘stunned myocardium’).
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Citro, Rodolfo, and Eduardo Bossone. "Diagnostic testing in takotsubo syndrome." In ESC CardioMed, 1294–98. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0319.
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At onset, takotsubo syndrome (TTS) resembles the clinical picture of an acute coronary syndrome. The most frequent electrocardiographic findings are ST-segment elevation, T-wave inversion, and Q waves. The detection of ST-segment depression in lead aVR is associated with high specificity with TTS and can be useful for early suspicion. Although increased serum troponin levels are reported in about 90% of patients, the concentrations of troponin and other cardiac necrosis enzymes are usually lower in TTS than in acute myocardial infarction. Transthoracic echocardiography is the first-line non-invasive imaging modality in the acute phase showing a depressed left ventricular (LV) ejection fraction, which recovers within few days or weeks. LV wall motion abnormalities extend beyond the territory of distribution of a single coronary artery and involve symmetrically the LV walls (‘circumferential pattern’). Echocardiography also provides additional information regarding the presence of reversible significant mitral regurgitation, LV outflow tract obstruction, right ventricular involvement, and intraventricular thrombi. Coronary angiography is the cornerstone of diagnosis since TTS is characterized by the absence of atherothrombotic lesions of the epicardial coronary arteries. Coronary computed tomography angiography is an alternative to coronary angiography only in stable and pain-free patients showing the typical features of TTS, especially if coronary angiography is not readily available. Cardiac magnetic resonance is useful in patients with poor acoustic windows or with suspected TTS and incomplete LV myocardial function recovery during follow-up, helping to exclude a different aetiology. Nuclear imaging tests can be performed for prognostic purposes during the acute and subacute phase.
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Stuart, Graham, and Guido E. Pieles. "The athlete’s heart in children and adolescents." In The ESC Textbook of Sports Cardiology, edited by Antonio Pelliccia, Hein Heidbuchel, Domenico Corrado, Mats Börjesson, and Sanjay Sharma, 32–41. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780198779742.003.0004.
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Athlete’s heart occurs in childhood but is less well understood than in adults. In children, exercise-related cardiac remodelling occurs but with more heterogeneity than in adults. It can be difficult to distinguish age-related cardiac maturation, exercise-related adaptation, and the early manifestation of cardiac disease such as cardiomyopathy. The initial assessment of a child with possible athlete’s heart includes a detailed history (medical, family, and exercise), comprehensive physical examination, ECG, and echocardiography. Congenital and structural heart disease should be excluded and the pubertal stage should be considered when interpreting findings. Investigations should be interpreted according to somatic size (using centiles) and pubertal stage rather than chronological age. Ethnic variations in physiology should be identified. If in doubt, child athletes with possible ethnically related changes should be followed up until maturity. T-wave inversion in anteroseptal leads is usually normal before puberty but abnormal after puberty. Lateral T-wave inversion is usually abnormal at any age. Voltage criteria for left ventricular hypertrophy are common in healthy child athletes. The presence of pathological Q waves, T-wave inversion, and ST-segment depression requires exclusion of cardiomyopathy. Most child athletes’ heart chamber size is within the normal reference ranges for age/gender, but hypertrophic cardiomyopathy should be considered in adolescent athletes with wall thickness >12mm (girls >11mm).
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Halder, Basudev, Sucharita Mitra, and Madhuchhanda Mitra. "Healthcare Automation System by Using Cloud-Based Telemonitoring Technique for Cardiovascular Disease Classification." In Research Anthology on Telemedicine Efficacy, Adoption, and Impact on Healthcare Delivery, 474–93. IGI Global, 2021. http://dx.doi.org/10.4018/978-1-7998-8052-3.ch025.
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This paper illustrates the cloud-based telemonitoring framework that implements healthcare automation system for myocardial infarction (MI) disease classification. For this purpose, the pathological feature of ECG signal such as elevated ST segment, inverted T wave, and pathological Q wave are extracted, and MI disease is detected by the rule-based rough set classifier. The information system involves pathological feature as an attribute and decision class. The degree of attributes dependency finds a smaller set of attributes and predicted the comprehensive decision rules. For MI decision, the ECG signal is shared with the respective cardiologist who analyses and prescribes the required medication to the first-aid professional through the cloud. The first-aid professional is notified accordingly to attend the patient immediately. To avoid the identity crisis, ECG signal is being watermarked and uploaded to the cloud in a compressed form. The proposed system reduces both data storage space and transmission bandwidth which facilitates accessibility to quality care in much reduced cost.
Conference papers on the topic "Segment ST-T"
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Greenhut, S. E., B. H. Chadi, J. W. Lee, J. M. Jenkins, and J. M. Nicklas. "A template boundary algorithm for ST-T segment analysis." In Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE, 1988. http://dx.doi.org/10.1109/iembs.1988.94380.
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Hadjem, Medina, Farid Nait-Abdesselam, and Ashfaq Khokhar. "ST-segment and T-wave anomalies prediction in an ECG data using RUSBoost." In 2016 IEEE 18th International Conference on e-Health Networking, Applications and Services (Healthcom). IEEE, 2016. http://dx.doi.org/10.1109/healthcom.2016.7749493.
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Khullar, N., A. Ibrahim, J. Saunders, C. Ahern, K. Mannix, C. Cahill, and TJ Kiernan. "16 Prognostic value of high-sensitivity cardiac troponin T in patients with ST-segment-elevation myocardial infarction." In Irish Cardiac Society Annual Scientific Meeting & AGM, Thursday October 4th – Saturday October 6th 2018, Galway Bay Hotel, Galway, Ireland. BMJ Publishing Group Ltd and British Cardiovascular Society, 2018. http://dx.doi.org/10.1136/heartjnl-2018-ics.16.
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Kordenat, K., and J. Leasure. "PROTECTIVE EFFECT OF CARNITINE (ST-261, SIGMA-TAU) IN ACUTE MYOCARDIAL INFARCTION IN DOGS." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1643012.
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Limitation of infarct size (IS), using ST-261, was evaluated in a group (I) of eight dogs, during acute MI. Another group (II) served as the control group. The protocol for both groups was the same except that each dog in the treated group was ST-261 as a single bolus (25 mg/kg, in 20ml normal saline), before inducing an occluding thrombus in the mid-LAD, using a closed-chest model, under x-ray visualization. Percentages of total (gms) myocardium at jeopardy (TMJW) and myocardial necrosis (TMNW), delineated by fluoroscein and TTC dyes, respectively, were calculated and compared to the total ventricular myocardial weight (TVMU), by computer technique for both groups at 3 Hrs post-occlusion of the LAD. Mean serum total CPK (CPK-t) and isozymes (mb-band) were measured before and up to 3 Hrs post-occlusion, as were various hemodynamic and mean precordial (21 lead) ST-segment and T-wave amplitudes. There was 14% less TMJU (p<0.05) and 41% less TMNW (p<0.01) in Group I compared to Group II. The mean % of CPK-mb/CPK-t decreased in I and increased in II over the 3 Hrs of observation. Mean HR decreased (p<0.01) in I compared to II at 3 Hrs postocclusion. The sum of the mean T-wave amplitudes from the precordial electrode sites was less in I at 3 Hrs. It is felt that ST-261 had a protective effect on the myocardium during acute myocardial infarction.
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Abboud, S., A. Beker, and B. Strasberg. "Analysis of high frequency MID-QRS potentials vs ST segment and T wave analysis for the diagnosis of ischemic heart disease." In Computers in Cardiology, 2003. IEEE, 2003. http://dx.doi.org/10.1109/cic.2003.1291281.
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Oktivasari, Prihatin, M. Hasyim, Amy HS, Freddy H, and Suprijadi. "A Simple Real-Time System for Detection of Normal and Myocardial Ischemia in The ST segment and T Wave ECG Signal." In 2019 International Conference on Information and Communications Technology (ICOIACT). IEEE, 2019. http://dx.doi.org/10.1109/icoiact46704.2019.8938461.
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Palliyali, Abdul Jaleel, Reza Tafreshi, Nasreen Mohsin, and Leyla Tafreshi. "A Comprehensive Algorithm for the Analysis of ECG Waveforms." In ASME 2012 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2012. http://dx.doi.org/10.1115/imece2012-87553.
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This paper presents a comprehensive approach for the detailed analysis of ECG waveforms including various morphologies to aid clinical diagnosis. Clinical judgment is often based on observing various features which may occur simultaneously on the ECG. Thus, to automate diagnosis, a comprehensive tool capable of detecting all these features is required. Parabolic curve fitting, adaptive thresholds and synchronicity across leads are utilized to detect the various waves of the QRS complex namely Q,R,S,R’ and S’. Onset of the QRS complex and the J point are detected using a ‘modified second derivative’ approach. The isoelectric level is detected using linearity and slope conditions. P and T waves are detected using ‘area under curve’ approach. Measurements such as peak-to-peak intervals and ST elevation/depression are numerically calculated from the points obtained. Curve fitting and change in slope are utilized for obtaining morphology of the ST segment. Presence of significant Q waves and abnormal T waves are inferred using clinical guidelines and numerical calculations. The performance of the algorithm is validated on 40 sample patient data — 20 healthy and 20 with Myocardial Infarction. Average accuracy shown in detecting all points of interest is 98.5%. All measurements are successfully calculated from these points. Along with this reliable performance, the approach proves to be simple and computationally fast.
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McGill, D., J. McGuiness, and N. Ardlie. "PLATELET FUNCTION ASSOCIATED WITH EXERCISE INDUCED MYOCARDIAL ISCHAEMIA: MODIFICATION BY COMBINED BETA-BL0CKER AND CALCIUM ENTRY BLOCKER THERAPY." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1643011.
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The relationship between platelet activation and exercise induced myocardial ischaemia is controversial, and the presence of measurable effects of anti-anginal drugs on platelet function requires further clarification. This study addresses these questions in patients with coronary artery disease (CAD), treated with metoprolol and nifedipine. Twenty seven clinically stable males aged 35 to 69 years (mean 53) with proven CAD, ceased all medications for 5 days, were maximally exercised on a treadmill, and then commenced treatment for 4 weeks. They were exercised to the same workload on treatment and again without drugs one week later. Blood samples were collected immediately before and after exercise in each of the three tests, to measure serum thromboxane B2 (TXB2). Myocardial ischaemia was assessed by ST segment depression. Statistical analysis was performed on paired and grouped data using the appropriate T-test. Baseline TXB2 levels were significantly lower in patients with exercise induced ischaemia, and this group had a significant increase in TXB2 production after exercise (Table). This increase was inhibited by therapy. .Those with a negative test had higher baseline TXB2 levels which not increase with exercise.It is concluded that myocardial ischaemia is associated with a lower potential for TXB2 production. It is also associated with an exercise induced increase in TXB2 which is prevented by anti-ischaemic drugs. It is suggested that continuous platelet activation may occur in CAD patients with ischaemia, depleting the potential for TXB2 production.
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Freire, Fernanda Fonsêca Monteiro, Bárbara Monique De Freitas Vasconcelo, Caio Marques Da Silva, Juliana Minervina De Souza Freire, and Luisy Karen Lemos Costa. "DIAGNOSTICANDO A ESTENOSE AÓRTICA: EXAMES DIFERENCIAIS." In II Congresso Brasileiro de Saúde On-line. Revista Multidisciplinar em Saúde, 2021. http://dx.doi.org/10.51161/rems/1501.
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Introdução: A estenose aórtica é uma doença causada pelo defeito da valva semilunar aórtica, que fica localizado no ventrículo esquerdo, e faz ligação com a artéria aorta. Através dessa abertura reduzida da valva, o sangue arterial não consegue manter o fluxo correto, o que causa disfunção na irrigação sanguínea pelo corpo. Portanto, é fundamental compreender as manifestações clínicas da estenose aórtica para um diagnóstico correto fidedigno. Objetivos: Compreender e entender a interpretação dos exames utilizados no diagnóstico da estenose aórtica afim de o diferenciar de outras patologias associadas a lesão valvar. Material e métodos: Foi realizada uma revisão de literatura integrativa usando os bancos de dados Unimep e Manual MSD, aplicando os descritores “Estenose aórtica” “Estreitamento valvar” e “Marcadores bioquímicos em lesões no miocárdio”. Usou-se como critério de inclusão os artigos em inglês e português que estivessem no período entre os anos de 2015 a 2021. Resultados: Para o diagnóstico diferencial da estenose aórtica, é necessária a realização de exames complementares, como, ecocardiografia que irá contabilizar a sobrecarga ventricular esquerda, com relação ao grau de disfunção sistólica, dimensionando possíveis valvopatias coexistentes e suas complicações, analisando a gravidade da patologia associada. O eletrocardiograma demonstra uma sobrecarga do ventrículo esquerdo, podendo apresentar ou não um padrão isquêmico no segmento ST-T. E uma radiografia de tórax a fim de observar a possível calcificação das cúspides aórticas, com possíveis evidências de insuficiência cardíaca. A necessidade da realização do cateterismo cardíaco para determinar a doença coronariana, com a finalidade de distinguir e orientar o médico para qual conduta deverá seguir, sendo esses métodos necessários e adequados para estabelecerem a diferenciação entre a estenose aórtica e a doença coronariana. Conclusão: A estenose aórtica pode ser confundida com diversas patologias pelos seus sinais e sintomas serem similares, como a doença arterial coronariana. Em geral, é bastante evidente mas quando o sopro tem características incomuns a estenose aórtica pode ser confundida com diversas condições. Sendo assim, os exames complementares são fundamentais para o diagnóstico diferencial.