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Prehospital 12-lead ST-segment monitoring improves the early diagnosis of acute coronary syndrome
Journal of Electrocardiology, 05/14/2012
Hemsey JKZ et al. – Prehospital electrocardiogram (ECG) data obtained with 12–lead ST–segment monitoring provides diagnostic information about acute coronary syndrome (ACS) above and beyond the initial hospital ECG.
Methods- Authors studied 620 patients who activated “911” for chest pain symptoms to determine the sensitivity and specificity of 12–lead electrocardiogram (ECG) ST–segment monitoring in the prehospital period (PH ECG) for diagnosing acute coronary syndrome (ACS) and to assess whether the addition of PH ECG signs of ischemia/injury to the initial hospital 12–lead ECG obtained in the emergency department would improve the diagnosis of ACS.
- The sensitivity and specificity of the PH ECG were 65.4% and 66.4%.
- There was a significant increase in sensitivity (79.9%) and decrease in specificity (61.2%) when considered in conjunction with the initial hospital ECG (P < .001).
- Those with PH ECG ischemia/injury were more than 2.5 times likely to have an ACS diagnosis than those who had no PH ECG ischemia/injury (P < .001).