Three patients with chest pain and “normal” ECGs: which had OMI? Which were normal? And how did the Queen of Hearts perform?

This study had such low risk patients that not a single patient was ultimately diagnosed with ACS.  It is well known that NOMI usually has a normal ECG or nonspecific ECG. The fact that not a single one of these patients had ACS shows that the population studied could not possibly support their conclusion. It should never have been published.According to this data a triage ECG labeled ‘normal’ rules out the possibility of acute coronary occlusion.This is obviously unreliable data, as Dr. Smith ’s Blog has published51 cases of OMI with ECGs labeled ‘normal’, 35 of which were identified by the Queen of Hearts – with 10 exampleshere. We also studied 7 years of Code STEMI patients requiring emergent reperfusion, and found that 4% presented with an ECG labeled ‘normal’, often confirmed by the final blinded interpretation. This was just published in print in this month ' s Academic Emergency Medicine:McLaren, Meyers, Smith and Chartier. Emergency department Code STEMI patients with initial electrocardiogram labeled ‘normal’ by computer interpretation: a 7-year retrospective review. Acad Emerg Med 2024;31:296-300Many of these ' normal ' ECGs had signs of OMI, and those that were identified in real time by the treating emergency physician had faster reperfusion than those that were missed. This study only included patients admitted as Code STEMI, which likely underestimates the false ‘normal’ rate because it doesn’t include those admitted a...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs