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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

Etiologies and predictors of ST-segment elevation myocardial infarction

Myung Hwan Bae1, Sang Soo Cheon, Joon Hyuk Song

  • 1Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.

Korean Circulation Journal
|July 25, 2013
PubMed

Insights

False-positive ST-segment elevation myocardial infarction (STEMI) diagnoses occurred in 7.5% of patients, often due to conditions mimicking STEMI. Careful ECG interpretation can reduce unnecessary catheterization lab activation.

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Diagnostic Imaging

Background:

  • Rapid diagnosis of ST-segment elevation myocardial infarction (STEMI) is critical for patient management.
  • False-positive STEMI diagnoses can lead to inappropriate cardiac catheterization.

Purpose of the Study:

  • To determine the prevalence, causes, and predictors of false-positive STEMI diagnoses.
  • To identify factors leading to unnecessary catheterization lab activation.

Main Methods:

  • Retrospective analysis of 455 patients with presumptive STEMI diagnosis.
  • Multivariate logistic regression to identify predictors of false-positive diagnoses.

Main Results:

  • 34 patients (7.5%) had false-positive STEMI diagnoses.
  • Common causes included coronary spasm, left ventricular hypertrophy, and myocarditis.
  • Delayed presentation, non-chest pain symptoms, absence of Q waves, and lack of reciprocal ECG changes predicted false positives.

Conclusions:

  • False-positive STEMI diagnoses are not uncommon, leading to unnecessary procedures.
  • Accurate ECG interpretation and considering alternative diagnoses are essential to prevent inappropriate catheterization.
Abstract

Keywords:
False positive reactionsMyocardial infarction

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