Do you want to be interrupted to view what the computer calls normal or nonspecific ECGs? 2 cases at once!

Two CasesMale PatientI was handed this ECG of a 40-something male patient.  It was recorded at triage.  The chief complaint was " chest pain. "The computer interpretation was " Nonspecific "What do you think?Female PatientAt the exact same time, I was viewing the computer queue of unconfirmed ECGs (read by computer but not yet overread by physician) and saw this one from a 40-something woman, about whom I knew nothing:The computer interpretation was: " Normal ECG "What do you think?Male Patient:When I saw the first one, on a 40-something male, I knew it was anewinferior MI (minimal STE in III with reciprocal STD in aVL, without another explanation), but it looked like it might be subacute or reperfused because the T-wave is inverted in lead III andreciprocally uprightin aVL.Female patient: When I saw the 2nd one, I immediately suspectedhyperacute inferior MI.Why?1. The inferior T-waves are too large2. There is T-wave inversion in aVL3. There is T-wave inversion in V2, suggestive of posterior MII looked in the EHR to find the patient, saw she was in triage, and went to locate her there.  She was sitting quietly in the waiting room.  She stated she had one hour of chest tightness.I brought her by wheelchair to the ED to a room and recorded this ECG 15 minutes after the first one:This time the computer called it: " Moderate ST depression. "Of course, it is actually clearly an acute inferior MI, even though (as is so frequent) it does not meet " STEMI criteria...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs