- Fellowship in 1989
Graduated from University of Hong Kong in 1984 and trained in the University Department of Medicine, Queen Mary hospital, Dr Wong's research work on electrocardiography (ECG) and coronary disease started in the 2 years (1989-1991) as a Croucher Foundation Fellow in Australia.
The original plans on training and research there did not eventuate, but he had the opportunity of applying his own ideas on some research results of an aborted project on right coronary artery thallium injection in patients undergoing angioplasty. He thought that correlation of this regional myocardial uptake with arterial branches of the artery would allow an angiographic score to develop, quantifying the arterial distribution. He went on collecting data on ECG findings particularly those of major heart attacks (results of total occlusion of the coronary artery), correlating with angiographic findings and the new score. This resulted in 3 subsequently published papers and a first submitted (mid 1991) version of MD thesis entitled “Precordial ST depression during inferior ST elevation: mechanism and significance”.
Dr Wong's MD thesis was kept by the chief examiner. He almost conceded that any work on the century-old ECG would never be high-sounding. Nonetheless, he persevered on the data he collected, researching what every aspect of a simple ECG tracing could mean scientifically in the context of a heart attack. In 1995, the University of Hong Kong officially invited him to “resubmit” his thesis – the final version contained eight published peer-reviewed papers plus an invited article. This work kept him pursuing the “ECG language of heart attack” till today.
In mid 1997, he left for New Zealand spending the major part of next 4+ years in Green Lane hospital as a researcher, while going through “re-certification” processes to become a New Zealand clinical cardiologist. He wrote articles on ECG findings on the HERO-1 trial and went on refining the ECG database of the 17,073 patient HERO-2 trial, prospectively studying ECGs before and 60 minutes after reperfusion treatment. Both trials were on major heart attacks.
In 2003, he joined the Dunedin School of Medicine, Otago University as an associate Professor. He is publishing mainly clinical papers on ECGs and coronary disease. He teaches medical students ECGs –simple concepts that direct clinical management. For the heart, surface electrical signals reflect physiological and pathological processes. Modern technologies such as smart phones with dedicated apps, etc allow these signals to be captured, transmitted, centralized, and analysed. Their utility is incremental with newer technology, but the findings from ECG studies always form the scientific backbone for any clinical application.
In 2015, he retired from the Otago University. After teaching in the Chinese University of Hong Kong as an adjunct Professor for several years, he returned to clinical service in the HA Hong Kong West cluster hospitals as a part-time consultant (Cardiology). Listed below are some of his publications, ending with the last article from his MD thesis in 1996. He records his thanks to the Croucher Foundation.
- Wong CK, et al. The prognostic meaning of the full spectrum aVR ST segment changes in acute myocardial infarction. European Heart Journal 2012; 33:384-92
- Wong CK, et al. Prognostic value of lead V1 ST elevation during acute inferior myocardial infarction. Circulation 2010; 122:463-9.
- Wong CK, et al. Initial Q waves accompanying ST-segment elevation at presentation of acute myocardial infarction and 30-day mortality in patients given streptokinase therapy: an analysis from HERO-2. Lancet 2006; 367:2061-7.
- Wong CK, et al. Risk stratification of patients with acute anterior myocardial infarction and right bundle-branch block: importance of QRS duration and early ST-segment resolution after fibrinolytic therapy. Circulation 2006;114:783-9
- Wong CK, etal. Prognostic differences between different types of bundle branch block during the early phase of acute myocardial infarction: insights from the Hirulog and Early Reperfusion or Occlusion (HERO)-2 trial. European Heart Journal 2006; 27:21-8
- Wong CK, et al. Patients with prolonged ischemic chest pain and presumed-new left bundle branch block have heterogeneous outcomes depending on the presence of ST-segment changes. Journal American College of Cardiology 2005; 46:29-38.
- Wong CK, et al. In the transition from fibrinolysis to primary PCI, the HERO trials help refine STEMI ECG interpretation and Q wave analysis potentially alters future management. European Heart Journal Acute Cardiovascular Care 2018; epub ahead of print
- Wong CK. Simplifying electrocardiographic assessment in STEMI reperfusion management: Pros and Cons. International Journal of Cardiology 2017; 227:30-36.
- Wong CK, et al. Q waves and failed ST resolution: Will intra-myocardial haemorrhage be a concern in reperfusing "late presenting" STEMIs? International Journal of Cardiology 2015; 182:203-210
- Wong CK. Intra-myocardial hemorrhage in STEMI reperfusion: An alternative explanation for failures from "augmented" fibrinolysis regimes and fibrinolysis-facilitated PCI? International Journal of Cardiology 2015; 184:766-8
- Wong CK, etal. The HERO-2 ECG sub-studies in patients with ST elevation myocardial infarction: implications for clinical practice. International Journal of Cardiology 2013; 170:17-23
- Wong CK, et al. Reperfusion in acute inferior myocardial infarction in the 1990s: could tailored therapy be based on precordial ST depression? American Heart Journal 1996; 131:1240-1246