European heart journal
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European heart journal · Feb 2000
Randomized Controlled Trial Clinical TrialOptimizing the initial 12-lead electrocardiographic diagnosis of acute myocardial infarction.
The optimum definition of ST elevation for diagnosis of acute myocardial infarction, with respect to both the minimum height and the minimum numbers of leads, is unknown. Furthermore, only 50% of patients with acute myocardial infarction present with ST elevation. We thus quantified the sensitivity and specificity of different ST elevation criteria for diagnosis of acute myocardial infarction, and determined whether models incorporating multiple QRST features in addition to ST elevation, could improve detection of acute myocardial infarction. ⋯ Different definitions of 'significant' ST elevation led to marked variations in sensitivity and specificity for diagnosis of acute myocardial infarction. Multiple QRST features in addition to ST elevation only marginally improved overall classification.