Electrocardiogram and cardiac magnetic resonance imaging relationship in the location of previous myocardial infarction
Abstract
Introduction: The performance of the electrocardiogram and its potential utility to confirm the topographic diagnosis of previous myocardial infarction according to cardiac magnetic resonance imaging is a very useful technique.
Objective: To determine the relationship between the electrocardiogram and the cardiac magnetic resonance imaging with respect to the location of previous myocardial infarction.
Method: A cross-sectional study, was carried out between 2017 and 2018 at the Centro de Investigaciones Médico-Quirúrgicas and the Instituto de Cardiología y Cirugía Cardiovascular, of Havana, Cuba. Cardiac magnetic resonance imaging with gadolinium was performed in a Magnetom Aera 1.5 T equipment and the infarct location was evaluated according to the electrocardiogram. The presence and pattern of late gadolinium enhancement were determined.
Results: Ninety-three patients were studied with predominance of men (86%). High blood pressure was the most frequent cardiovascular risk factor (69.9%). The correlation of late gadolinium enhancement with the electrocardiogram showed that 90.5% of previous anterior wall myocardial infarctions presented late enhancement in that location. In inferior myocardial infarctions, subendocardial involvement predominated (66.7%), as did indeterminate ones (66.7%). There were 57 cases with demonstrated scarring by cardiac magnetic resonance imaging; among them, only 40% of those with complete left bundle branch block.
Conclusions: Cardiac magnetic resonance imaging confirmed the presence of myocardial necrosis in the majority of patients with Q waves in the electrocardiogram, which continues supporting its use for this purpose. There is a high relationship between the infarct location by both diagnostic tests.
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