A woman in her 30's with h/o HTN presented with atypical chest pain after a stressful event. Here is her ED ECG:
I think that the formula would be more accurate if it took into account the entire QRS, not just the R-wave. I will be using all the original ECGs to study this hypothesis.
There were no previous ECGs for comparison.
We did a bedside cardiac echo which showed concentric LVH and a well functioning anterior wall. A repeat ECG 30 minutes later was identical. We recommended admission for further evaluation but the patient signed out against medical advice.
Her heart rate came down with IV fluids.
I am quite certain that this is the patient's baseline ECG.
1. LVH can result in PseudoSTEMI patterns of various morphologies. Here are some others.
2. The formula may give false positives in LVH