title: Consideration of pitfalls in and omissions from the current ECG standards for diagnosis of myocardial ischemia/infarction in patients who have acute coronary syndromes.
abstract: The ECG is the key clinical test available for the emergency determination of which patients who presenting with acute coronary syndromes indeed have acute myocardial ischemia/infarction. Because typically the etiology is thrombosis, the correct clinical decision regarding reperfusion therapy is crucial. This review follows the efforts of an AHA working group to develop new standards for clinical application of electrocardiology. The pitfalls in the current diagnostic standards regarding ischemia/infarction that have been identified by sufficiently documented studies are corrected in their report. This article focuses on the pitfalls for which new standards will emerge in future years.
authors.affiliation: Division of Cardiology, Department of Medicine, Duke University Medical Center, 2400 Pratt Street, RM 0306, Durham, NC 27705, USA, and Department of Clinical Physiology, Lund University Hospital, Sweden. Galen.wagner@duke.edu
authors.forename: Galen
authors.initials: G
authors.lastname: Wagner
authors.forename: Tobin
authors.initials: T
authors.lastname: Lim
authors.forename: Leonard
authors.initials: L
authors.lastname: Gettes
authors.forename: Anton
authors.initials: A
authors.lastname: Gorgels
authors.forename: Mark
authors.initials: M
authors.lastname: Josephson
authors.forename: Hein
authors.initials: H
authors.lastname: Wellens
authors.forename: Stanley
authors.initials: S
authors.lastname: Anderson
authors.forename: Rory
authors.initials: R
authors.lastname: Childers
authors.forename: Peter
authors.initials: P
authors.lastname: Clemmensen
authors.forename: Paul
authors.initials: P
authors.lastname: Kligfield
authors.forename: Peter
authors.initials: P
authors.lastname: Macfarlane
authors.forename: Olle
authors.initials: O
authors.lastname: Pahlm
authors.forename: Ronald
authors.initials: R
authors.lastname: Selvester
mesh_terms: D000789:Angina, Unstable / Q000150:complications*; D004562:Electrocardiography / Q000379:methods / Q000592:standards*; D006801:Humans; D017202:Myocardial Ischemia / Q000175:diagnosis*