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More than meets the eye: False code STEMI.

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A novel square wave artifact on electrocardiograms can mimic ST elevation myocardial infarction. Early identification prevents unnecessary, harmful treatments for patients with suspected heart attacks.

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Area of Science:

  • Cardiology
  • Medical Diagnostics
  • Biomedical Engineering

Background:

  • Accurate electrocardiogram (ECG) interpretation is crucial for diagnosing ST elevation myocardial infarction (STEMI).
  • Artifacts on ECGs can lead to misdiagnosis, potentially causing harm.
  • Unnecessary treatments for STEMI include pharmacotherapy and invasive procedures.

Observation:

  • A previously unreported pervasive square wave artifact was observed on a resting ECG.
  • This artifact was erroneously interpreted as ST segment elevation.
  • Both computer software and initial physician review misidentified the artifact.

Findings:

  • The square wave artifact mimicked ST elevation, posing a diagnostic challenge.
  • Misdiagnosis could lead to inappropriate pharmacotherapy and invasive procedures.
  • This highlights the need for vigilance in artifact recognition.

Implications:

  • Clinicians must be aware of this specific artifact to prevent diagnostic errors.
  • Improved ECG analysis algorithms may be needed to detect such artifacts.
  • Recognizing artifactual ST elevation is essential for appropriate STEMI management and patient safety.