False Positive ST-Segment Elevation Myocardial Infarction

Acute ST-segment elevation myocardial infarction (STEMI) is a serious disease in clinical practice. The rapid and accurate diagnosis of this critical illness can lead to prompt reperfusion, and it enables the reduction of cardiac ischemic damage and results in improved subsequent outcomes. The shorter the time to reperfusion, the greater the benefits. The American College of Cardiology/American Heart Association STEMI guidelines recommend primary percutaneous coronary intervention for the treatment of STEMI with a doorto-balloon time of less than 90 minutes. Therefore, the prompt and accurate diagnosis of STEMI is an important issue. In the diagnosis of STEMI, the 12-lead electrocardiogram (ECG) is an indispensable diagnostic tool directing the emergent management of patients with acute STEMI. However, a variety of other conditions aside from STEMI can cause ST-segment elevation on the ECG. Several recent studies have found a frequency of false-positive catheterization laboratory activation. Indeed, a false-positive STEMI diagnosis is relatively common in community practice. One of these studies reported that the prevalence of false-positive cardiac catheterization laboratory activations was between 9.2-14%. In another study, the prevalence of false-positive STEMI diagnosis was 10.4% and the characteristics and prognosis in patients with a false-positive STEMI diagnosis in an emergency department was investigated. In this study, false-positive STEMI diagnosis patients had a lower incidence of typical chest pain or chest tightness. Inferior ST-segment Editorial