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Challenges in Clinical Electrocardiography
October 2015

ST-Segment Elevation Interpretation on ElectrocardiogramTo Cath or Not to Cath?

Author Affiliations
  • 1Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
JAMA Intern Med. 2015;175(10):1695-1697. doi:10.1001/jamainternmed.2015.3989

The 12-lead electrocardiogram (ECG) is a diagnostic tool in cardiology and similar to other diagnostic tests is also susceptible to misinterpretation. Understanding the principles of ECG acquisition is essential to accurate interpretation. The reported cases highlight the importance of applying these principles to challenging scenarios in which the ECG is the most important investigation conducted to guide clinical decision-making.

A woman in her 50s with no cardiac risk factors was assessed in an outpatient cardiology clinic for paroxysmal atrial fibrillation and atypical chest pain. Her initial ECG is shown in Figure 1A.

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