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False ST-segment elevation by artifact due to an infusion pump.

Juan C Garcia-Rubira1, Isabel Sanchez-Medina1, Jose A Rodríguez-Velazquez1

  • 1Coronary Care Unit, University Hospital Virgen Macarena, Sevilla, Spain.

Journal of Electrocardiology
|April 9, 2023
PubMed
Summary

Electrocardiogram (ECG) ST-segment elevation in acute coronary syndrome patients can be a monitor artifact from saline bolus infusion. Careful clinical correlation is essential for accurate ECG interpretation.

Keywords:
Electrocardiographic artifactInfusion pumpKuramoto's modelMonitoringST-segment elevation

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Area of Science:

  • Cardiology
  • Medical Instrumentation
  • Clinical Diagnostics

Background:

  • Non-ST-elevation acute coronary syndrome (NSTE-ACS) requires precise electrocardiogram (ECG) interpretation.
  • Monitoring for cardiac events is crucial in hospitalized patients.

Purpose of the Study:

  • To report a case of artifactual ST-segment elevation mimicking myocardial infarction.
  • To emphasize the importance of correlating ECG findings with clinical context and other physiological data.

Main Methods:

  • Continuous ECG monitoring was performed on a patient admitted for NSTE-ACS.
  • A saline bolus was administered via an infusion pump.
  • ECG changes were observed during and after the saline administration.

Main Results:

  • Transient ST-segment elevation artifact was observed on the ECG monitor during saline bolus infusion.
  • The artifact disappeared upon completion of the saline bolus.
  • No actual ST-segment elevation myocardial infarction was diagnosed.

Conclusions:

  • Infusion pump-related artifacts can mimic significant ECG abnormalities like ST-segment elevation.
  • Accurate ECG interpretation necessitates a comprehensive approach, integrating clinical presentation and physiological parameters.
  • Clinicians must be aware of potential technical artifacts that can influence diagnostic decisions.