Feb 22, 2022 00:21
2 yrs ago
29 viewers *
English term
ST segments concordant
English to German
Medical
Medical: Cardiology
Frankly, I do not know how to ask this properly, and what language pair it should actually be grouped under to reach the right audience (I do not want to put it under EN monolingual).
I am editing the following:
"EKG showed sinus rhythm at a rate of 75 beats per minute, left type, PQ unremarkable, ST segments concordant."
This was written in English by an Austrian clinician. Hence, we need to think backwards what she meant to say in German as they usually translate literally. But I've seen neither "concordant ST segments" nor "konkordante ST-Strecken" in any real-life reports.
I need to make sense of it and put it in proper medical English.
Any suggestions in German or English what exactly was meant here?
Thank you!
P.S.Disregard the "left type", we know it's "horizontal heart"
I am editing the following:
"EKG showed sinus rhythm at a rate of 75 beats per minute, left type, PQ unremarkable, ST segments concordant."
This was written in English by an Austrian clinician. Hence, we need to think backwards what she meant to say in German as they usually translate literally. But I've seen neither "concordant ST segments" nor "konkordante ST-Strecken" in any real-life reports.
I need to make sense of it and put it in proper medical English.
Any suggestions in German or English what exactly was meant here?
Thank you!
P.S.Disregard the "left type", we know it's "horizontal heart"
Proposed translations
(German)
| 4 | konkordante ST-Strecke |
Marga Shaw
|
| 3 | unauffällige ST-Strecken / keine (auffälligen) ST-Streckenveränderungen |
Steffen Walter
|
Change log
Feb 22, 2022 10:47: Steffen Walter changed "Field (write-in)" from "cardiology" to "(none)"
Proposed translations
2 days 11 hrs
Marga Shaw
United Kingdom
United Kingdom
Native in German
Works in field
United Kingdom
Language matters
Native in: German (Variants: Austrian, Germany, Swiss)
Works in: English to German, German to English
Related KudoZ points
:
24
Selected
konkordante ST-Strecke
auch: konkordantes ST-Segment
Sgarbossa A: konkordante ST-Segment Elevation > 1 mm in zumindest einer Ableitung (5 Punkte)
oder
Sgarbossa B: konkordante ST-Segment Depression von mindestens 1 mm in Ableitung V1, V2 oder V3 (3 Punkte)
https://foamina.blog/2015/05/25/stemi-bei-linksschenkelblock...
Modifizierte Sgarbossa-Kriterien: Ermöglichen Diagnose eines STEMI bei Linksschenkelblock [16]
Ansatz: Konkordanz der ST-Streckenveränderungen
Diagnose eines STEMI: Sobald eines der folgenden drei Kriterien positiv ausfällt
Konkordante ST-Hebung ≥1 mm
ST-Senkung ≥1 mm in V1-V3
Diskordante exzessive ST-Hebung ≥25% vom S und ≥1 mm (bzw. ST-Streckenhebung ≥5 mm in Ableitungen mit einem negativen QRS-Komplex)
https://www-amboss-com.db.rsu.lv/de/wissen/Myokardinfarkt/
Please also see my Discussion Entries above.
Sgarbossa A: konkordante ST-Segment Elevation > 1 mm in zumindest einer Ableitung (5 Punkte)
oder
Sgarbossa B: konkordante ST-Segment Depression von mindestens 1 mm in Ableitung V1, V2 oder V3 (3 Punkte)
https://foamina.blog/2015/05/25/stemi-bei-linksschenkelblock...
Modifizierte Sgarbossa-Kriterien: Ermöglichen Diagnose eines STEMI bei Linksschenkelblock [16]
Ansatz: Konkordanz der ST-Streckenveränderungen
Diagnose eines STEMI: Sobald eines der folgenden drei Kriterien positiv ausfällt
Konkordante ST-Hebung ≥1 mm
ST-Senkung ≥1 mm in V1-V3
Diskordante exzessive ST-Hebung ≥25% vom S und ≥1 mm (bzw. ST-Streckenhebung ≥5 mm in Ableitungen mit einem negativen QRS-Komplex)
https://www-amboss-com.db.rsu.lv/de/wissen/Myokardinfarkt/
Please also see my Discussion Entries above.
4 KudoZ points awarded for this answer.
Comment: "Thanks, Marga!"
10 hrs
Steffen Walter
Germany
Germany
Native in German
Germany
Top-Notch Service | Direct Clients Only
Native in: German (Variant: Germany) 
Works in: English to German, German to English, French to German, and 1 more.
Related KudoZ points
:
60
unauffällige ST-Strecken / keine (auffälligen) ST-Streckenveränderungen
This is what I'd normally expect in a German cardiology report. This ECG seems to be unremarkable overall. See also https://www.proz.com/kudoz/german-to-english/medical-cardiol... and https://www.proz.com/kudoz/german-to-english/medical-cardiol...
Peer comment(s):
| neutral |
liz askew
: hmm this doesn't address "concordance", which has negative connotations.
6 hrs
|
|
Yes, perhaps, but all of the findings listed before ("sinus rhythm at a rate of 75 beats per minute, left type, PQ unremarkable") seem to be unremarkable/normal.
|
Reference comments
2 hrs
andres-larsen
Venezuela
Venezuela
Native in English
Venezuela
freelance translator
Native in: English 
Works in: Spanish to English, English to Spanish, German to English, and 3 more.
Related KudoZ points
:
8
Reference:
übereinstimmende ST Segmente oder Strecken
EKG für Rettungsdienst und Notfallmedizin
https://books.google.com › books·
Matthias Jahn, Frank Löwe · 2019 · Medical
MERKE konkordant = übereinstimmend Kammerkomplex und T-Welle sind konkordant. ... der Übergangspunkt vom Ende des Kammerkomplexes zum Beginn der ST-Strecke.
https://books.google.com › books·
Matthias Jahn, Frank Löwe · 2019 · Medical
MERKE konkordant = übereinstimmend Kammerkomplex und T-Welle sind konkordant. ... der Übergangspunkt vom Ende des Kammerkomplexes zum Beginn der ST-Strecke.
10 hrs
Reference:
meaning
Sgarbossa criteria | Learn the Heart - Healiohttps://www.healio.com › cardiology-review › topic-reviews
Sgarbossa Criteria · ST elevation > 1 mm and ****in the same direction (concordant) with the QRS complex***. 5 points · ST depression > 1 mm in leads V1, V2, or V3. 3 ...
--------------------------------------------------
Note added at 10 hrs (2022-02-22 10:49:32 GMT)
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STEMI in the Presence of LBBB | Emergency Physicians Monthlyhttps://epmonthly.com › article › stemi-in-the-presence-...
***“Concordance” (ST segment in the same direction as the QRS)*** is abnormal ... of discordant ST elevation to be positive for the “unweighted” Sgarbossa rule.
--------------------------------------------------
Note added at 10 hrs (2022-02-22 10:51:05 GMT)
--------------------------------------------------
LBBB in Patients With Suspected MI: An Evolving Paradigmhttps://www.acc.org › articles › 2017/02/28 › lbbb-in-p...
28 Feb 2017 — Among stable patients, ECG analysis to assess for ****ST-segment concordance ****criteria, along with serial cardiac biomarker testing and bedside ...
--------------------------------------------------
Note added at 15 hrs (2022-02-22 16:21:30 GMT)
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LBBB: is there STEMI? - Dr. Smith's ECG Bloghttp://hqmeded-ecg.blogspot.com › 2011/05 › lbbb-is-t...
21 May 2011 — Concordance: ST segment is in the same direction as the majority of the QRS Discordance: ST segment is in the opposite direction to the ...
--------------------------------------------------
Note added at 16 hrs (2022-02-22 16:25:01 GMT)
--------------------------------------------------
https://www.acc.org/latest-in-cardiology/articles/2017/02/28...
The most widely accepted tools to aid in the diagnosis of MI in the presence of LBBB are the Sgarbossa criteria. Sgarbossa et al.1 identified three ECG criteria that may improve the diagnosis of MI in patients with LBBB:
ST-elevation of ≥1 mm and concordant with the QRS complex (5 points)
ST-segment depression ≥1 mm in lead V1, V2, or V3 (3 points)
ST elevation ≥5 mm and discordant with the QRS complex (2 points)
ST-segment concordance with the QRS complex has a specificity approaching 98% but with limited sensitivity (~20%) (Table 1).5 Thus, the Sgarbossa criteria are informative if present but not reassuring if absent and cannot be used to exclude MI.
--------------------------------------------------
Note added at 16 hrs (2022-02-22 16:30:37 GMT)
--------------------------------------------------
https://www.nejm.org/doi/full/10.1056/nejm199602223340801
RESULTS
Of 26,003 North American patients, 131 (0.5 percent) with acute myocardial infarction had left bundle-branch block. ***The three electrocardiographic criteria with independent value in the diagnosis of acute infarction in these patients were ST-segment elevation of 1 mm or more that was concordant with (in the same direction as) the QRS complex****; ST-segment depression of 1 mm or more in lead V1, V2, or V3; and ST-segment elevation of 5 mm or more that was discordant with (in the opposite direction from) the QRS complex. We used these three criteria to develop a scoring system (0 to 5), which allowed a highly specific diagnosis of acute myocardial infarction to be made.
--------------------------------------------------
Note added at 16 hrs (2022-02-22 16:35:23 GMT)
--------------------------------------------------
https://epmonthly.com/article/stemi-in-the-presence-of-lbbb/
****The diagnosis of STEMI in LBBB*** is dependent on the “Rule of Appropriate Discordance,” which means that, in normal LBBB (without MI), the ST segment (and usually T-wave) are in the opposite direction (discordant to) the majority of the QRS. ****“Concordance” (ST segment in the same direction as the QRS) is abnormal and indicates STEMI.**** Sgarbossa and others have found high specificity of an ST segment that is concordant to the QRS.
--------------------------------------------------
Note added at 16 hrs (2022-02-22 16:36:33 GMT)
--------------------------------------------------
So, based on the above evidence I don't think it is "unremarkable". Concordance indicates STEMI.
--------------------------------------------------
Note added at 16 hrs (2022-02-22 16:39:38 GMT)
--------------------------------------------------
and the above is possible with a HR of 70 bpm
see:
False-positive ST-segment elevation | European Heart Journalhttps://academic.oup.com › ehjcr › article
by V Sudmantaitė · 2020 · Cited by 3 — A 12-lead ECG (Figure 1) revealed a heart rate of 70 b.p.m. and an ST-segment elevation (1 mm) in leads II, III, aVF, and V1–V6.
Sgarbossa Criteria · ST elevation > 1 mm and ****in the same direction (concordant) with the QRS complex***. 5 points · ST depression > 1 mm in leads V1, V2, or V3. 3 ...
--------------------------------------------------
Note added at 10 hrs (2022-02-22 10:49:32 GMT)
--------------------------------------------------
STEMI in the Presence of LBBB | Emergency Physicians Monthlyhttps://epmonthly.com › article › stemi-in-the-presence-...
***“Concordance” (ST segment in the same direction as the QRS)*** is abnormal ... of discordant ST elevation to be positive for the “unweighted” Sgarbossa rule.
--------------------------------------------------
Note added at 10 hrs (2022-02-22 10:51:05 GMT)
--------------------------------------------------
LBBB in Patients With Suspected MI: An Evolving Paradigmhttps://www.acc.org › articles › 2017/02/28 › lbbb-in-p...
28 Feb 2017 — Among stable patients, ECG analysis to assess for ****ST-segment concordance ****criteria, along with serial cardiac biomarker testing and bedside ...
--------------------------------------------------
Note added at 15 hrs (2022-02-22 16:21:30 GMT)
--------------------------------------------------
LBBB: is there STEMI? - Dr. Smith's ECG Bloghttp://hqmeded-ecg.blogspot.com › 2011/05 › lbbb-is-t...
21 May 2011 — Concordance: ST segment is in the same direction as the majority of the QRS Discordance: ST segment is in the opposite direction to the ...
--------------------------------------------------
Note added at 16 hrs (2022-02-22 16:25:01 GMT)
--------------------------------------------------
https://www.acc.org/latest-in-cardiology/articles/2017/02/28...
The most widely accepted tools to aid in the diagnosis of MI in the presence of LBBB are the Sgarbossa criteria. Sgarbossa et al.1 identified three ECG criteria that may improve the diagnosis of MI in patients with LBBB:
ST-elevation of ≥1 mm and concordant with the QRS complex (5 points)
ST-segment depression ≥1 mm in lead V1, V2, or V3 (3 points)
ST elevation ≥5 mm and discordant with the QRS complex (2 points)
ST-segment concordance with the QRS complex has a specificity approaching 98% but with limited sensitivity (~20%) (Table 1).5 Thus, the Sgarbossa criteria are informative if present but not reassuring if absent and cannot be used to exclude MI.
--------------------------------------------------
Note added at 16 hrs (2022-02-22 16:30:37 GMT)
--------------------------------------------------
https://www.nejm.org/doi/full/10.1056/nejm199602223340801
RESULTS
Of 26,003 North American patients, 131 (0.5 percent) with acute myocardial infarction had left bundle-branch block. ***The three electrocardiographic criteria with independent value in the diagnosis of acute infarction in these patients were ST-segment elevation of 1 mm or more that was concordant with (in the same direction as) the QRS complex****; ST-segment depression of 1 mm or more in lead V1, V2, or V3; and ST-segment elevation of 5 mm or more that was discordant with (in the opposite direction from) the QRS complex. We used these three criteria to develop a scoring system (0 to 5), which allowed a highly specific diagnosis of acute myocardial infarction to be made.
--------------------------------------------------
Note added at 16 hrs (2022-02-22 16:35:23 GMT)
--------------------------------------------------
https://epmonthly.com/article/stemi-in-the-presence-of-lbbb/
****The diagnosis of STEMI in LBBB*** is dependent on the “Rule of Appropriate Discordance,” which means that, in normal LBBB (without MI), the ST segment (and usually T-wave) are in the opposite direction (discordant to) the majority of the QRS. ****“Concordance” (ST segment in the same direction as the QRS) is abnormal and indicates STEMI.**** Sgarbossa and others have found high specificity of an ST segment that is concordant to the QRS.
--------------------------------------------------
Note added at 16 hrs (2022-02-22 16:36:33 GMT)
--------------------------------------------------
So, based on the above evidence I don't think it is "unremarkable". Concordance indicates STEMI.
--------------------------------------------------
Note added at 16 hrs (2022-02-22 16:39:38 GMT)
--------------------------------------------------
and the above is possible with a HR of 70 bpm
see:
False-positive ST-segment elevation | European Heart Journalhttps://academic.oup.com › ehjcr › article
by V Sudmantaitė · 2020 · Cited by 3 — A 12-lead ECG (Figure 1) revealed a heart rate of 70 b.p.m. and an ST-segment elevation (1 mm) in leads II, III, aVF, and V1–V6.
Discussion
As Anne pointed out correctly, the term is usually assigned to T-Waves, not ST-Segments. This, however, is the minor flaw of the Austrian clinician's literal English translation. I would just leave it...
Marga, why not just post your discussion entry as an answer...?
... findings of ST segment concordance on the 12 lead ECG (similar to the Sgarbossa’s Criteria for LBBB) were concerning and quite specific for a diagnosis of Acute Myocardial Infarction.
https://emergencypedia.com/2013/09/16/sgarbossa-criteria-in-...
The study resulted in Sgarbossa criteria; 3 independent predictors of MI in setting of LBBB
1.) ST segment concordance of 1mm any lead (greatest odd ratio, i.e. most specific)...
https://umem.org/educational_pearls/1778/
... The ST segment is an interval between ventricular depolarization and ventricular repolarization. It is identified as the end of the QRS complex to the beginning of the T wave. ...
https://www.medscape.com/answers/1894014-178294/what-is-the-...
GE: https://flexikon.doccheck.com/de/Sgarbossa-Kriterien
EN: https://litfl.com/sgarbossa-criteria-ecg-library/
There are quite a number of good other references both in English (concordance) and in German (Konkordanz).
For example:
concordant ST elevatioon / concordant ST depression (English)
konkordante ST-Hebung / konkordante ST-Senkung (German)
Sorry, I am a bit pushed today. HTH - a bit