Failure to Identify High-Risk ECG Findings in AMI Patients

Identifying acute myocardial ischemia in the emergency department is essential for providing prompt and appropriate medical therapy. These authors evaluated the frequency with which ED providers at five hospitals missed electrocardiogram evidence of acute myocardial infarction and the possible effects of missed findings on quality of care.

The authors retrospectively reviewed the medical records of 1684 consecutive patients who presented to the EDs of five Kaiser Permanente–affiliated hospitals and received a discharge diagnosis of AMI. Patients with both ST–segment-elevation MI and non-STEMI were included. The authors were unable to characterize the identities, training, or experience of the clinicians who had interpreted the electrocardiog…