Acid Reflux or Posterior Myocardial Infarction: One ECG Away From a Missed Diagnosis
Heith Waddell1, Ariel J Gjovig, Wesley D Davis
1Crook County Medical Services District, Sundance, Wyoming (Dr Waddell); University of Washington School of Medicine, Seattle (Ms Gjovig); and College of Nursing, University of South Alabama, Mobile (Dr Davis).
Abstract:
Health care professionals and hospitals have made tremendous advances in detecting, diagnosing, and treating posterior myocardial infarction over many decades. Electrocardiogram (ECG) alone is used to make a timely diagnosis of ST-segment elevation myocardial infarction in the emergency department. The typical signs of myocardial infarction, left-sided chest discomfort with radiation to the jaw or left arm, rule out a wide range of patient presentations with ST-segment elevation myocardial infarction. This variation in clinical symptoms is exacerbated by the fact that most ECG monitors lack algorithms that account for posterior myocardial infarction interpretation. Therefore, health care practitioners must exercise caution when dismissing nondiagnostic and faint ECG abnormalities as normal or unimportant.
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