I was reading ECGs on the system when I came across this one, called " normal " by the conventional computer algorithm

I come in early for every shift to read the ECGs on the system that have not yet been " confirmed " .  I came across this one:The computer calls is: " SINUS RHYTHM. NORMAL ECG "What do you think? Be VERY careful when the computer calls the ECG " Normal " .  I saw the inferior ST depression (which is reciprocal to subtle STE in aVL) and the subtle ST depression in precordial leads and thought:" If this patient came in with chest pain, then it is an acute OMI. "So I looked on the computer.  Turns out that it was a 50-something patient with no previous cardiac history who had called 911 for chest pain and had presented 75 minutes earlier by ambulance to triage (as the entire ED was overloaded).  After the ECG was recorded, he was placed in the waiting room where he had been for over an hour.  All triage ECGs are immediately shown to triage ED faculty.I went to triage and showed the ECG to our triage faculty, who is VERY good at reading OMI on the ECG, and he immediately recognized the findings. In his hurried state he had not looked closely enough, probably because the computer had said " NORMAL ECG, " AND because a bunch of misinformed authors have propagated the idea that we need not look at triage ECGs that the computer calls " NORMAL. "I sent this ECG to the Queen of Hearts (PMcardio OMI), and here is the verdict:We brought the patient to the stabilization room.  The patient stated that hispain was now much better, suggesting spon...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs