AMI M

• While EKG computer readings have limited accuracy, one ignores them at one’s peril, especially when they report an abnormality. They can be wrong, but so can we. We can’t assume we’re smarter than that computer. If we do, we must clearly document our reason for disagreement. (1)
• Also keep in mind that the EKG computer interpretation may miss subtle EKG findings. If you are concerned with “nonsignificant” EKG changes, obtain repeat EKG and maintain your suspicion of ACS. See this post from Dr.  Smith’s ECG blog on subtle EKG changes.
• In chest pain patients with equivocal findings, such as HEART score of 4 or greater, further testing for risk stratification is recommended.
• When doing follow-up on a recently hospitalized patient, obtain and read the medical record.
• And finally, there is no lower age limit below which a patient cannot have an MI (or PE or aortic dissection)