This was texted to me in real time. The patient has acute chest pain.

 This was texted to me in real time. The patient has acute chest pain.What do you think?Here was my answer:" Not ischemia. Chronic. Maybe HOCM or another form of LVH.  I would not activate cath lab.  Get serial troponins "It is a scary ECG, with a lot of ST Elevation and what appear to be hyperacute T-waves in inferior leads, and profound reciprocal ST Depression in aVL.  There are Q-waves in V4-V6, with what appear to be hyperacute T-waves.  Any objective, rule-based analysis of this ECG would scream " STEMI " or " OMI " .  But, alas, ECGs are like faces.  No measurements can tell you the identity of the face.  It must be recognized.  And I recognized this as a STEMI mimic.  I told them so and thus they did NOT activate the cath lab, but measured serial troponins.The patient ruled out for MI by serial troponins.We are training the Queen of Hearts AI algorithm to recognized these cases, but we need to train her with a lot more false positives.In this case, QOH wasincorrect, saying " OMI High confidence. "I sent this ECG to the Queen of Hearts (PMcardio OMI), and here is the verdict:===================================MY Comment, by KEN GRAUER, MD (7/5/2023):===================================Today ' s case is instructive for a number of reasons: i) As good as the QOH (Queen Of Hearts) AI algorithm already is — it is not perfect; — and, ii) ...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs