Table 5

Common ECG Pitfalls in Diagnosing Myocardial Infarction

False positives
  •  • Early repolarization

  •  • LBBB

  •  • Pre-excitation

  •  • J point elevation syndromes, e.g. Brugada syndrome

  •  • Peri-/myocarditis

  •  • Pulmonary embolism

  •  • Subarachnoid hemorrhage

  •  • Metabolic disturbances such as hyperkalemia

  •  • Cardiomyopathy

  •  • Lead transposition

  •  • Cholecystitis

  •  • Persistent juvenile pattern

  •  • Malposition of precordial ECG electrodes

  •  • Tricyclic antidepressants or phenothiazines

False negatives
  •  • Prior Ml with Q-waves and/or persistent ST elevation

  •  • Right ventricular pacing

  •  • LBBB