Identifying ST-segment changes in patients with LVH is frequently associated with false-positive diagnoses of acute coronary syndrome
This study analyzed the ACTIVATE-SF database, a registry of consecutive emergency department STEMI diagnoses from 2 medical centers (411 patients)
In patients with anterior territory ST-elevation, using a ratio of ST segment to R-S–wave magnitude >25% as a diagnostic criteria for STEMI significantly improved specificity for an angiographic culprit lesion (true positive)
Although this rule requires further study in a larger population it may augment current criteria for determining which patients with ECG LVH should undergo PCI
References
Armstrong E, Kulkarni A, et al. Electrocardiographic Criteria for ST-Elevation Myocardial Infarction in Patients With Left Ventricular Hypertrophy. Am J Cardiol 2012;110:977–983.
