Consideration of pitfalls in and omissions from the current ECG standards for diagnosis of myocardial ischemia/infarction in patients who have acute coronary syndromes.
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.
Wagner
Galen
G
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
Lim
Tobin
T
Gettes
Leonard
L
Gorgels
Anton
A
Josephson
Mark
M
Wellens
Hein
H
Anderson
Stanley
S
Childers
Rory
R
Clemmensen
Peter
P
Kligfield
Paul
P
Macfarlane
Peter
P
Pahlm
Olle
O
Selvester
Ronald
R
D000789:Angina, Unstable / Q000150:complications*; D004562:Electrocardiography / Q000379:methods / Q000592:standards*; D006801:Humans; D017202:Myocardial Ischemia / Q000175:diagnosis*