The ECG in Acute Myocardial Infarction and Unstable Angina

Every time a patient presents with acute chest pain, the challenge is to make, as soon as possible, the correct diagnosis of presence, size, site and severity of myocardial ischemia. The electrocardiogram is the only tool able to do so immediately, in a non-invasive way and at low cost. Recently, new information has become available allowing us to recognize where in the coronary artery the culprit lesion is located and thereby estimate the size of the area of the heart which is jeopardized. This is of obvious importance in determining the aggressiveness of our therapy. Will we select a thrombus dissolving drug or opt for an invasive coronary intervention? In myocardial ischemia rhythm and conduction disturbances are often present. Again, proper ECG interpretation under these circumstances is essential for management of the patient and future risk assessment. When reperfusion of the acutely ischemic area is attempted by thrombolytic therapy or a percutaneous coronary intervention the ECG is important to inform us about the result. Not only in acute myocardial infarction but also in unstable angina the size, site and severity of cardiac ischemia is of great importance. Again that information can be provided by the electrocardiogram. All this new information is thoroughly discussed by members of the internationally recognized Maastricht school of electrocardiography. The book is a must for any healthcare professional engaged in the management of the patient with acute chest pain.