Electrocardiographic diagnosis of acute myocardial infarction

The widely recognized benefits of early diagnosis and treatment of acute my ocardial infarction (AMI) have only emphasized the importance of emergency physician (EP) competence in electrocardiographic interpretation. As such, the EP must be an expert in the interpretation of the electrocardiogram (EC G) in the emergency department chest pain center patient. The ECG is a powe rful clinical tool used in the evaluation of patients, assisting in making the diagnosis of AMI and other syndromes, selecting appropriate therapies ( including thrombolysis and primary angioplasty), securing the location of a n adequate inpatient disposition, and predicting the risk of cardiovascular complications and death. This article will discuss the appropriate uses of the ECG in the patient with possible or confirmed AMI and review the typic al electrocardiographic findings of AMI, diagnostically confounding pattern s, mimickers of infarction, and new techniques.