Related Experiment Videos

Improved Detection of Acute Coronary Occlusion Myocardial Infarction by an Artificial Intelligence Electrocardiogram

Thomas Lindow1,2, Axel Nyström3, Jakob Lundager Forberg4,5

  • 1Respiratory Medicine, Allergology, and Palliative Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.

Journal of the American College of Emergency Physicians Open
|August 19, 2026
PubMed

Insights

The Queen of Hearts (QoH) AI model significantly improves detection of occlusion myocardial infarction (OMI) in chest pain patients. QoH shows higher sensitivity and positive predictive value than STEMI criteria, aiding faster diagnosis.

Area of Science:

  • Cardiology
  • Artificial Intelligence in Medicine
  • Emergency Medicine

Background:

  • Occlusion myocardial infarction (OMI) detection is critical in emergency departments (EDs).
  • Current ST-elevation myocardial infarction (STEMI) criteria have limitations in diagnosing OMI.
  • The Queen of Hearts (QoH) artificial intelligence (AI) model shows promise for improved OMI detection.

Purpose of the Study:

  • To evaluate the diagnostic performance of the QoH AI model for OMI detection.
  • To compare QoH's performance against conventional STEMI criteria and other algorithms in chest pain patients.
  • To validate QoH in a real-world Swedish emergency department setting.

Main Methods:

  • Retrospective analysis of 24,511 consecutive chest pain patients from the ESC-TROP study (2017-2018).
  • OMI classification based on angiographic data and expert adjudication.
  • Comparison of QoH, conventional STEMI, extended STEMI criteria, and Glasgow ECG Analysis Algorithm performance.

Main Results:

  • 467 patients (1.9%) had OMI.
  • QoH demonstrated significantly higher sensitivity (52% vs. 23%) and positive predictive value (51% vs. 17%) compared to STEMI criteria.
  • QoH achieved similar specificity (99%) and negative predictive value (99%) as STEMI criteria.

Conclusions:

  • The QoH AI model significantly improves OMI detection sensitivity in emergency department patients with chest pain.
  • QoH offers comparable specificity to existing criteria, making it a valuable tool for OMI diagnosis.
  • Further validation supports QoH as a potentially superior AI-driven ECG analysis tool for acute cardiac events.
Abstract

Keywords:
ST depressionST elevationacute coronary occlusionacute myocardial infarctionartificial intelligencediagnostic accuracy

Related Concept Videos

Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
Cardiopulmonary Resuscitation III: AED Use01:23

Cardiopulmonary Resuscitation III: AED Use

Introduction to AEDAn Automated External Defibrillator (AED) is a portable medical device that analyzes the heart's rhythm and, if necessary, delivers an electrical shock to help the heart re-establish an effective rhythm during sudden cardiac arrest (SCA). SCA occurs when the heart suddenly and unexpectedly stops beating, leading to a loss of blood flow to the brain and other vital organs. In such emergencies, time is of the essence, and using an AED, combined with Cardiopulmonary...