This ECG was interpreted as completely NORMAL by the computer: What about it is THE critical finding??

This study looked at less than 1000 cases, which is not nearly enough (see below for analysis) and they used cardiologists as the gold standard (a very poor gold standard), NOT presence or absence of Occlusion MI (which we have done in all of our ECG studies, and must be ascertained by 1) TIMI 0/2 flow on angiogram or 2) culprit + TIMI 3 flow and very high troponin. So this study is worthless and must be ignored.  And the Clay Smith at Journal Feed comment was right on.In our case, the emergency physician was well trained in identifying subtle LAD Occlusion MI and ignored the computer.I have here30 cases of " Computer Normal " ECGs which were critically abnormal and the vast majority aremissed acute coronary occlusions (Missed Acute OMI) and most were recognized by the physician.We wrote this Editorial in the Journal of Electrocardiology in 2019.  Litell JM, Meyers HP, Smith SW. Emergency physicians should be shown all triage ECGs, even those with a computer interpretation of “Normal.” J Electrocardiol [Internet] 2019;54:79–81. Available from: http://dx.doi.org/10.1016/j.jelectrocard.2019.03.003Excerpt:" To illustrate the limitations imposed by sample size, recent data from our institution reveal that we identify approximately 225 type I myocardial infarctions (MI) in a typical year. These include about 60 occlusion MI (OMI) with clear ST segment elevation (none of which would be called “Normal” by the computer) and about 165 Non-STEMI. Of t...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs