Chest pain and a computer ‘normal’ ECG. Therefore, there is no need for a physician to look at this ECG.

This article,published this month (!), tells us that we physicians do not need to even look at this ECG until the patient is placed in a room because the computer says it is normal:Validity of Computer-interpreted “Normal” and “Otherwise Normal” ECG in Emergency Department Triage PatientsI reviewed this article for a different journal and recommended rejection and it was rejected.  There were zero patients in this study with a " normal " ECG who had any kind of ACS!  This defies all previous data on acute MI which would show that even undetectable troponins do not have a 100% negative predictive value.  So this study is actually worthless.  On the other hand,if the physician is unable to recognize subtle OMI, as is the case with the overreading cardiologist, then the conclusion would be correct._____________ECG analysisThere ’s normal sinus rhythm, normal conduction, normal axis, normal R wave and normal voltages. What sticks out is the ST depression in aVL, which is reciprocal to subtle inferior ST elevation and bulky T waves.  There is also a down-up T-wave in aVL, which makes aVL even more diagnostic.  This is diagnostic is inferior OMI, accompanied by inferior Q waves, and with a flat ST segment in V2 that could indicate posterior extension.Old ‘NSTEMI’A history of coronary artery disease and a stent to the same territory further increases pre-test likelihood of acute coronary occlusion, including in-stent thrombosis. ...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs