@article{CDT3942,
author = {Shariq Shamim and Justin McCrary and Lori Wayne and Matthew Gratton and Douglas B. Bogart},
title = {Electrocardiograhic findings resulting in inappropriate cardiac catheterization laboratory activation for ST-segment elevation myocardial infarction},
journal = {Cardiovascular Diagnosis and Therapy},
volume = {4},
number = {3},
year = {2014},
keywords = {},
abstract = {Background: Prompt reperfusion has been shown to improve outcomes in patients with acute ST-segment elevation myocardial infarction (STEMI) with a goal of culprit vessel patency in <90 minutes. This requires a coordinated approach between the emergency medical services (EMS), emergency department (ED) and interventional cardiology. The urgency of this process can contribute to inappropriate cardiac catheterization laboratory (CCL) activations.
Objectives: One of the major determinants of inappropriate activations has been misinterpretation of the electrocardiogram (ECG) in the patient with acute chest pain.
Methods: We report the ECG findings for all CCL activations over an 18 month period after the inception of a STEMI program at our institution.
Results: There were a total of 139 activations with 77 having a STEMI diagnosis confirmed and 62 activations where there was no STEMI. The inappropriate activations resulted from a combination of atypical symptoms and misinterpretation of the ECG (45% due to anterior ST-segment elevation) on patient presentation. The electrocardiographic abnormalities were particularly problematic in African-Americans with left ventricular hypertrophy.
Conclusions: In this single-center, prospective observational study, nearly half of the inappropriate STEMI activations were due to the misinterpretation of anterior ST-segment elevation and this finding was commonly seen in African-Americans with left ventricular hypertrophy.},
issn = {2223-3660}, url = {https://cdt.amegroups.org/article/view/3942}
}