Pseudo-Myocardial Infarction Versus Pseudo-Pseudo-Myocardial Infarction
Pseudo-Myocardial Infarction Versus Pseudo-Pseudo-Myocardial Infarction
Pseudo-Myocardial Infarction Versus Pseudo-Pseudo-Myocardial Infarction
1
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2 Correspondence
ECGs, which were performed with another ECG machine, pathway; such a change includes an elevated ST segment and
revealed similar findings. The likelihood of interference by other tented T waves in the right precordial leads after elimination of
extrinsic factors, such as an arterial pulse (suggested by Dr the left accessory pathways. The repolarization changes after
Kessler), in producing the observed bizarre T waves cannot be successful ablation of accessory pathway is presumably due to
completely excluded. The bizarre T waves disappeared several “cardiac memory.”2
hours later, and the subsequent ECGs, which were not shown,
still revealed ST segment elevation with positive T waves in V1 Szu-Chun Hung, MD
to V3, and inverted T waves in V4 to V6. We think the key finding Chern-En Chiang, MD, PhD
was the ST segment elevation in the right precordial leads, Jen-Dar Chen, MD
especially V3, and we consider it a good example of pseudo- Philip Yu-An Ding, MD, PhD
myocardial infarction. Taipei Veterans General Hospital
The possibility of acute pericarditis, as suggested by Dr and National Yang-Ming University School of Medicine
Cheng, should be considered as well. However, the ST segments Taipei, Taiwan
in several leads, including leads I, II, and aVL, show depression cechiang@vghtpe.gov.tw
instead of elevation, a finding uncommon for pericarditis. The
list of causes of pseudoinfarction raised by Dr Cheng is impor- 1. Hung SC, Chiang CE, Chen JD, et al. Pseudo-myocardial infarction.
tant. Moreover, an intriguing ECG finding in the contemporary Circulation. 2000;101:2989 –2990.
era of interventional electrophysiology is the ST-T change after 2. Goldberger JJ, Kadish AH. Cardiac memory. Pacing Clin Electrophysiol.
radiofrequency catheter ablation of the accessory atrioventricular 1999;22:1672–1679.
Circulation. 2001;103:e69
doi: 10.1161/01.CIR.103.12.e69
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